People with chronic thromboembolic pulmonary hypertension (CTEPH) are more likely to have a depressive temperament, finds a Japanese study, “Depressive Status in Patients With Chronic Thromboembolic Pulmonary Hypertension” that appeared in the Circulation Journal.
CTEPH is a progressive disease characterized by increasing pulmonary vascular resistance. Although the underlying mechanism that causes it isn’t clear, patients with CTEPH have chronic blood clot formation in the pulmonary arteries, leading to pulmonary hypertension and right-sided heart failure. They also have depressive tendencies linked to chronic heart failure, though these tendencies have also been seen even in patients with early CTEPH and no heart symptoms.
To investigate the possible link between CTEPH and depression, Japanese researchers evaluated 40 patients diagnosed with CTEPH and 45 age-matched healthy volunteers. All participants completed a temperament and personality scale test, as well as the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR), a 16-item symptom severity rating scale associated to depressive symptoms.
Results showed that the two groups differed significantly only in depressive temperament. While 70 percent of the CTEPH patients showed signs of a depressive personality, only 33 percent of the healthy group displayed similar tendencies. Other parameters including irritable, anxious and melancholic temperaments showed no difference between the CTEPH and healthy groups.
QIDS-SR results confirmed the previous findings. Forty-one of the healthy volunteers, representing 91 percent of the group, showed no symptoms of depression with a final QIDS-SR score below 5. On the other hand, 15 patients with CTEPH — about 38 percent of the group — displayed symptoms of depression with a final QIDS-SR score above 6. This suggests that CTEPH patients are more susceptible to depression symptoms and a depressive temperament.
Nevertheless, no associations were found with disease severity.
The study’s authors evaluated CTEPH clinical severity according to the New York Heart Association classification and found no link between depressive status of CTEPH patients and a blood biomarker of heart overload (B-type natriuretic peptide) — nor with hemodynamic parameters such as mean pulmonary arterial pressure, pulmonary vascular resistance or cardiac output.
“The present study demonstrates that CTEPH patients have a significantly higher depressive status than healthy volunteers. It may be that CTEPH patients are more likely to have a depressive temperament in origin,” authors wrote, adding that their results concur with previous reports suggesting a link between depressive status and CTEPH. However, these studies showed that disease severity was related to depression and anxiety, which the present study didn’t confirm.