Park Da-Hee, Meltendorf Tanja, Kahl Kai G, Kamp Jan C, Richter Manuel J, Hoeper Marius M, Olsson Karen M, Fuge Jan
Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.
Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany.
Front Psychiatry. 2022 Feb 22;13:813506. doi: 10.3389/fpsyt.2022.813506. eCollection 2022.
Mental disorders are common in patients with pulmonary arterial hypertension (PAH) and contribute to impaired quality of life (QoL). The impact of mental disorders on access to health care, differences in clinical parameters and treatment in patients with PAH is unclear. In this study we sought to assess the impact of mental disorders and other health disparities on health-care-utilization in patients with PAH.
In a cross-sectional observational study of patients with PAH, mental disorders were characterized using a structed clinical interview. In addition, patients completed a self-administered questionnaire to assess QoL, symptoms of anxiety and depression, lifestyle-factors and educational status. Number of outpatient visits and communication events per year were calculated as a surrogate for health-care-utilization and were compared by the presence of mental disorder. Linear regression analysis was conducted to assess the impact on health-care-utilization.
117 patients with PAH participated in this study (70% female, median age 59 (interquartile range, 49-70) years). Significant differences between patients with or without mental disorders were found in anxiety, depression and QoL. There were no significant differences in clinical parameters. Patients with mental disorders had higher rates of outpatient visits and communication events than patients without mental disorders. Linear regression revealed a gain of 2.2 communication events per year in the presence of any mental disorders.
Mental disorders in patients with PAH are common and significantly affect health-care-utilization. This higher demand in patients with mental disorder needs to be addressed by physicians, psychiatrists and specialized nurses offering therapeutic strategies.
精神障碍在肺动脉高压（PAH）患者中很常见，会导致生活质量（QoL）受损。精神障碍对PAH患者获得医疗保健的影响、临床参数差异及治疗情况尚不清楚。在本研究中，我们试图评估精神障碍和其他健康差异对PAH患者医疗保健利用情况的影响。
在一项针对PAH患者的横断面观察性研究中，通过结构化临床访谈对精神障碍进行特征描述。此外，患者完成一份自我管理问卷，以评估生活质量、焦虑和抑郁症状、生活方式因素及教育状况。计算每年的门诊就诊次数和沟通事件数量作为医疗保健利用情况的替代指标，并按是否存在精神障碍进行比较。进行线性回归分析以评估对医疗保健利用情况的影响。
117例PAH患者参与了本研究（70%为女性，中位年龄59岁（四分位间距，49 - 70岁））。有或无精神障碍的患者在焦虑、抑郁和生活质量方面存在显著差异。临床参数无显著差异。有精神障碍的患者门诊就诊率和沟通事件发生率高于无精神障碍的患者。线性回归显示，存在任何精神障碍时，每年的沟通事件增加2.2次。
PAH患者中的精神障碍很常见，且显著影响医疗保健利用情况。医生、精神科医生和专业护士需要提供治疗策略来应对精神障碍患者的这种更高需求。
