Anxiety and Depression Screening of Youth in Pediatric Pulmonary Hypertension Clinic: A Multi-Center, Cross-Sectional Study.

Abstract

Children with chronic diseases, including pulmonary hypertension (PH), have an increased risk of anxiety and depression (AD), impacting mental health (MH), and quality of life (QoL). We sought to characterize the prevalence of AD in pediatric PH and identify associated factors. We developed a prospective cross-sectional study with 10 Pediatric Pulmonary Hypertension Network (PPHNet) centers. Eligible subjects aged 12-21, diagnosed with PH, and English or Spanish speaking, completed validated AD screening questionnaires during routine outpatient clinic visits. Caregivers provided socioeconomic status (SES) data and MH history via survey. Patient demographics and clinical characteristics were analyzed using standard descriptive statistics. Eighty-eight patients were enrolled (female = 54, 61%). Forty-six (51.7%) identified at least mild symptoms of AD. Females were more likely to report AD than males (OR 2.67, 95% CI 1.11-6.61, p = 0.030). There were no significant associations between AD and PH severity, MH history, family dynamics, SES status, race, or ethnicity. Twenty-seven of those patients (58.7%) received MH education/counseling by MH professionals; ten (21.7%) were referred to MH providers, and nine patients (19.6%) were assessed for suicide safety. Adolescents with PH have a high prevalence of AD. Female patients had increased AD compared to male patients; no other predictors were linked to the prevalence of AD. Routine AD screening should be integrated into outpatient PH clinic visits with a focus on psychosocial support for young females diagnosed with PH.