Employment Status, Pain, Low Physical Activity Linked to Anxiety, Depression in Hemophilia Patients

A study that examined the role of emotional distress in the lives of hemophilia patients found that a patient’s employment status, pain interference levels, perception of the detrimental consequences of hemophilia, and physical activity levels were all independently associated with symptoms of anxiety and depression.

The study, “Emotional distress in haemophilia: Factors associated with the presence of anxiety and depression symptoms among adults,” was published in the journal Haemophilia.

Hemophilia is a rare genetic disorder characterized by spontaneous bleeding. The current standard of treatment for patients includes factor replacement therapy.

Despite significant improvements in treatment over the last few decades, people with hemophilia still face many clinical challenges, including demanding treatment regimens, severe pain related to hemarthrosis (bleeding into the joints), hemophilic arthropathy (permanent joint disease), and the development of therapy inhibitors.

However, the effects of hemophilia extend beyond clinical issues and can include psychosocial problems such as uncertainty about health, social restrictions, and unemployment. Consequently, current guidelines for the optimal care of hemophilia include the promotion of psychosocial health.

It is important to identify modifiable factors that contribute to anxiety and depression in patients with hemophilia. This can allow physicians and researchers to develop tailored treatments to help patients improve overall outcomes.

Therefore, researchers set out to investigate the potentially modifiable factors associated with the presence of anxiety and depressive symptoms among adults with hemophilia.

Researchers conducted a cross-sectional observational study that examined sociodemographic, clinical, and psychosocial variables among 102 Portuguese patients with hemophilia A or B.

The results showed a significant impact of clinical characteristics on anxiety and depression.

Particularly, patients who had greater anxiety and depressive symptoms were more likely to have experienced urgent hospital visits due to hemophilia, more bleeding episodes, more affected joints and pain, and worse levels of perceived functionality and quality of life in the previous year.

Researchers also conducted a statistical analysis, controlling for demographics such as age and education, and clinical characteristics such as severity and joint deterioration. They sought to determine which factors were independently associated with anxiety and depression.

They found that patients who were unemployed, retired, or on medical leave were four times more likely to report anxiety and about three times more likely to report symptoms of depression.

Additionally, patients who experienced increased levels of pain interference were more likely to report anxiety and depression. Pain interference refers to the consequences of pain on various aspects of a person’s life. This can include social, cognitive, emotional, physical, and recreational activities.

Furthermore, an increased perception of the detrimental consequences of hemophilia was associated with an almost two-fold increase of the likelihood of having depressive symptoms.

Conversely, patients who are physically active are almost 70 percent less likely to have depressive symptoms compared to patients who live sedentary lifestyles.

Professional status, pain interference, the perception of detrimental consequences, and exercise are four modifiable risk factors that can contribute to or reduce depression and anxiety in patients with hemophilia.

“These highlight potential intervention targets, which are amenable to change through evidence-based tailored interventions aiming to decrease emotional distress, promote well-being and improving haemophilia-related health outcomes among these patients,” researches noted.