Short communicationDepressive symptoms in relation to physical functioning in pulmonary hypertension☆
Introduction
Pulmonary hypertension (PH) is a rare disabling chronic illness of the pulmonary circulation that leads to deterioration in cardiopulmonary function and eventually to right heart failure [1]. Patients with PH experience progressive breathlessness, fatigue, weakness, chest pain, and syncope [2]. The decline in cardiac function also leads to impaired physical function and quality of life [3], [4], [5], [6], [7]. Levels of emotional distress are increased in PH patients [8], and some research indicates a relationship between distress and functional impairment in PH [6], [8]. In this study, we investigate the association between depressive symptoms and physical functioning in PH patients while controlling for illness severity. We hypothesize that patients with PH and high levels of depressive symptoms will report worse physical functioning than those with low levels of depressive symptoms.
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Sample and procedures
The study protocol was approved by the Research Ethics Committee of the Sir Mortimer B. Davis—Jewish General Hospital. From June 2005 to October 2007, patients who were scheduled for elective cardiac catheterization for the investigation of PH were approached to participate in the study. The inclusion criteria for the study were age (18 years or older), ability to communicate in English or French, and ability to provide written informed consent. Participants received self-report questionnaires
Results
The sample consisted of 52 patients diagnosed with PH by cardiac catheterization. Table 1 presents the characteristics of the sample and compares participants with high levels of depressive symptoms (BDI scores of 17 or greater) and those with low levels of depressive symptoms (BDI scores less than 17) on physical functioning and other variables in the study.
Table 2 presents the results of the hierarchical regression. Analyses did not identify collinearity among the hemodynamic variables that
Discussion
In our study, patients had a mean physical functioning score of 32, comparable to a mean of 37 found in another study of PH patients [4], and much lower than the general population score of 82 for Canadians in this age group [17]. The mean BDI score in our sample was 11, indicating mild to moderate depressive symptoms, and 21% scored above 16 indicating moderate to severe depressive symptoms. This is consistent with previous studies in PH patients that reported a BDI score of 13 [4], the
Acknowledgments
This study was supported by funding from the Fonds de la Recherche en Santé du Québec. The investigators are supported by salary awards from the FRSQ (K.L., D.D., and D.L.) and graduate scholarship awards from the FRSQ and the Canadian Institutes of Health Research (A.P.).
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Note: Preliminary data of the study were presented as a poster at the 65th Annual Scientific Conference of the American Psychosomatic Society, Budapest, Hungary, March 2007, and published in Psychosomatic Medicine, 2007 Meeting Abstracts, Abstract 1249, p. A-44.