Depression, anxiety prevalent among hemophilia patients: Study
Analysis focused on 90 men with hemophilia A and B in Turkey
About a quarter (24.4%) of men with hemophilia A and B seen at a clinic in Turkey met the clinical threshold for depression, and nearly three-quarters (74.4%) had anxiety, according to a recent analysis.
Having a high school degree was linked to the presence of depression, whereas having hemophilia B was associated with anxiety.
“Mental health screening of this patient population for depression and anxiety should be considered by clinicians in Turkey, and possibly outside Turkey as well,” the researchers wrote. “The diagnosis and treatment of mental health problems in patients with hemophilia could make a major contribution to their quality of life.”
The study, “Depression and anxiety in people with hemophilia A and B,” was published in The International Journal of Psychiatry in Medicine.
The daily burden of chronic illness often has been linked to an increased prevalence of mood disorders including depression and anxiety.
Indeed, studies indicate that people with hemophilia, a chronic bleeding disorder, experience high rates of depression and anxiety that are linked to a lower quality of life.
Still, because these symptoms can be highly influenced by demographic and cultural factors, findings from various geographical regions tend to somewhat differ.
In this study, scientists evaluated the prevalence of depression and anxiety in adult hemophilia A and B patients seen at a hemophilia center in Turkey.
Patients seen at this center were screened for depression using the Beck Depression Inventory (BDI) and for anxiety with the State-Trait Anxiety Inventory (STAI) at their annual clinic visits.
Most hemophilia A patients were using preventive treatment
A total of 90 men with a median age of 35.5 years were included in the analysis. Most had hemophilia A (84.4%) and were using preventive treatment (87.8%). The median number of bleeding episodes was 5.5 per year.
Overall, 22 men (24.4%) met the criteria for significant depressive symptoms, defined as a score of at least 17 (out of a possible 63) on the BDI.
This rate was relatively low compared with previous reports, according to the scientists, which could possibly be related to coping mechanisms from living with the lifelong disease or the relatively young age of this study population.
The only clinical factor found to differ between patients with or without depression was educational status. Specifically, a high school degree was found to be significantly associated with depression in final statistical analyses. While many high school graduates experienced depressive symptoms, rates were markedly lower among both less educated and more educated patients.
“Education and related socioeconomic status seem to act as complex factors in developing depression among patients with hemophilia,” the researchers wrote. They speculated that uncertainties related to the future could contribute to these higher rates of depression in high-school educated patients.
State anxiety vs. trait anxiety
In terms of anxiety, 74.4% of patients were considered to have state anxiety, whereas 66.7% had trait anxiety. State anxiety refers to current feelings of anxiety, whereas trait anxiety is a more general measure of how prone a person is to being anxious.
Patients with hemophilia B had significantly higher state anxiety scores than people with hemophilia A, but no other clinical factors were linked to anxiety.
“This interesting issue needs to be investigated with more comprehensive cohort studies,” the researchers wrote.
According to the scientists’ experiences in the clinic, anxiety in hemophilia patients were often associated with social activities, emotional relationships, disability, and loss of financial and social support. Fear of bleeding, disability, and death contributed to anxiety about the future.
Researchers noted caution should be exercised when interpreting the study results due to its relatively small size.
Still, “we believe this study is of particular importance as it provides national data on the rates of depression and anxiety among patients with hemophilia,” they wrote. “Larger studies, particularly prospective studies, are needed to assess the true impact of this blood disorder on mental health.”