Psychological abnormalities are commonly present in adult patients with pulmonary Langerhans cell histiocytosis

Background: The prevalence of neuropsychiatric symptoms and substance abuse disorders, in adult patients with pulmonary Langerhans cell histiocytosis (PLCH) has not been explored. Objectives: The aim of this study was to examine the psychological healthcare burden faced by PLCH patients. Methods: All PLCH patients seen during one year completed the Hospital Anxiety and Depression scale (HAD), the Barratt Impulsiveness Scale, Version 10 (BIS-10) and the Cannabis Use Disorders Identification Test (CUDIT) questionnaires. Scores were used to determine the prevalence of psychological and substance abuse problems, and were associated with clinical assessment of the disease. The primary endpoint of the study was the proportion of patients having definite or doubtful anxious state (HAD-A scores of 11 or higher or between 8 and 10, respectively). Logistic regression models were used to quantify the strength of association of various disease-related parameters and the occurrence of anxiety, depression or impulsivity. Results: Sixty-eight patients were included. Definite anxious and depressive states were identified in 29% and 6% patients, respectively, and doubtful anxious and depressive states in 34% and 6%, respectively. Impulsive behaviour was detected in 13% of the cohort. Eleven patients (16%) consumed cannabis on a regular basis, and in 55% of them CUDIT scores suggested cannabis abuse or dependence. Increasing time from diagnosis and successful cessation of cigarette smoke exposure were associated with decreased risk of anxiety. Conclusions: Psychological abnormalities commonly co-exist in adult PLCH patients and should be considered while making their management decisions.