Factors Influencing Symptoms of Depression, Anxiety and Stress in Patients With Haemophilia

IF 3 2区医学 Q2 HEMATOLOGY

Haemophilia Pub Date : 2025-06-27 DOI:10.1111/hae.70079

Alexander Schmidt, Fabian Tomschi, Pia Möllers, Marius Brühl, Heinrich Richter, Johannes Oldenburg, Andreas Christian Strauss, Thomas Hilberg

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Abstract

Introduction

Patients with haemophilia (PwH) often suffer from psychological symptoms such as depression or anxiety. To date, uncertainty exists about the determinants predicting worse psychological outcomes. Therefore, this study aimed to investigate the extent of depressive, anxiety and stress-related symptoms in PwH compared to the healthy population and determine the impact of disease-specific and arthropathy-related parameters.

Methods

Levels of depression, anxiety, stress and overall emotional distress were queried in a total of 379 PwH and 271 healthy controls by handing out the Depression, Anxiety and Stress Scale 21. In addition, disease-specific variables (e.g., type, severity, viral infections), pain intensity (NRS from 0 to 10), pain persistence (Likert-scale from 1 to 6), pain sensitivity (pressure pain thresholds [PPT]) and the orthopaedic joint score (Haemophilia Joint Health Score v2.1; HJHS) were assessed to analyse associations with psychological symptoms.

Results

PwH had higher scores for depression, anxiety, stress and overall emotional distress compared to the healthy cohort. Regarding disease-specific outcomes, only PwH with hepatitis or HIV showed higher scores for depression (hepatitis, p = 0.020), stress (hepatitis, p = 0.005; HIV, p = 0.048) and overall emotional distress (hepatitis, p = 0.020). Spearman's rank correlation further revealed significant associations between NRS, pain persistence, PPT and HJHS with all psychological outcomes, though most effect sizes were weak.

Conclusion

These results provide further evidence for a poorer psychological profile in PwH compared to the healthy population. Particularly, pain-related outcomes, but also joint degeneration and the presence of viral infections, are related to enhanced psychological symptoms.

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血友病患者抑郁、焦虑和应激症状的影响因素

导读：血友病（PwH）患者常伴有抑郁或焦虑等心理症状。迄今为止，预测更糟糕心理结果的决定因素存在不确定性。因此，本研究旨在探讨与健康人群相比，PwH患者抑郁、焦虑和压力相关症状的程度，并确定疾病特异性和关节病相关参数的影响。方法：通过发放《抑郁、焦虑和压力量表21》，对379名PwH和271名健康对照者的抑郁、焦虑、压力和整体情绪困扰水平进行调查。此外，疾病特异性变量（如类型、严重程度、病毒感染）、疼痛强度（NRS从0到10）、疼痛持续性（李克特量表从1到6）、疼痛敏感性（压痛阈值[PPT]）和骨科关节评分(血友病关节健康评分v2.1；评估HJHS)与心理症状的关系。结果：与健康人群相比，PwH在抑郁、焦虑、压力和整体情绪困扰方面得分更高。在疾病特异性结局方面，只有患有肝炎或艾滋病毒的PwH在抑郁（肝炎，p = 0.020）、压力(肝炎，p = 0.005；HIV, p = 0.048)和整体情绪困扰（肝炎，p = 0.020）。Spearman等级相关进一步揭示了NRS、疼痛持续性、PPT和HJHS与所有心理结局之间的显著相关，尽管大多数效应量较弱。结论：与健康人群相比，这些结果进一步证明PwH患者的心理状况较差。特别是，与疼痛相关的结果，以及关节变性和病毒感染的存在，都与心理症状的增强有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Haemophilia 医学-血液学

CiteScore

6.50

自引率

28.20%

发文量

226

审稿时长

3-6 weeks

期刊介绍： Haemophilia is an international journal dedicated to the exchange of information regarding the comprehensive care of haemophilia. The Journal contains review articles, original scientific papers and case reports related to haemophilia care, with frequent supplements. Subjects covered include: clotting factor deficiencies, both inherited and acquired: haemophilia A, B, von Willebrand''s disease, deficiencies of factor V, VII, X and XI replacement therapy for clotting factor deficiencies component therapy in the developing world transfusion transmitted disease haemophilia care and paediatrics, orthopaedics, gynaecology and obstetrics nursing laboratory diagnosis carrier detection psycho-social concerns economic issues audit inherited platelet disorders.