Key result
Current depression or panic disorder in PAH is linked to significantly more dysfunctional metacognitions.
Why the study?
Mental disorders are increased in patients with pulmonary arterial hypertension, but the pathogenic mechanisms determining their development remain unclear.
Cross-Sectional (n=217)
Yes
In patients with pulmonary arterial hypertension, dysfunctional metacognitions are associated with major depressive disorder and panic disorder, highlighting a potential target for psychological interventions.
Dysfunctional metacognitions were associated with MDD/PD in PAH; hypothesis-generating for metacognitive interventions, prospective studies required before clinical consideration.
Background The prevalence of mental disorders, particularly adjustment disorder (AD), major depressive disorder (MDD) and panic disorder (PD) is increased in patients with pulmonary arterial hypertension (PAH). However, it is unclear which pathogenic mechanisms determine their development and could therefore be targeted in prevention or therapeutic interventions. Here, we assessed metacognitions in a sample of PAH patients with and without MDD and PD. Moreover, we reconstructed the course of mental illnesses following the PAH diagnosis. Methods Two hundred seventeen PAH patients were included in this cross-sectional study. The prevalence of AD was assessed retrospectively using DSM-V criteria. Current mental disorders were assessed using the structured clinical interview for DSM-V. Additionally, metacognitive beliefs and processes were assessed using established questionnaires (MCQ-30, AnTI). Results Patients with an AD consecutive to the PAH diagnosis more frequently developed MDD (37.5 vs. 13.9%, p < 0.001) and PD (26.3 vs. 8.8%, p = 0.001) later on compared to PAH patients without a former AD. Moreover, patients with current MDD/PD displayed more dysfunctional metacognitions than those without current MDD/PD ( p < 0.001). Patients with current MDD/PD in the context of former AD had more dysfunctional metacognitive worries and beliefs compared to patients with current MDD/PD without former AD ( p = 0.009). Conclusion Our results suggest that in the context of PAH, dysfunctional metacognitions are associated with MDD and PD. Therefore, a metacognitive approach to treat and prevent those mental illnesses seems promising and should be investigated in future studies.
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Caldarone et al. (2022) conducted a cross-sectional in Pulmonary Arterial Hypertension (n=217). Current major depressive disorder (MDD) or panic disorder (PD) vs. No current MDD/PD was evaluated on Anxious Thoughts Inventory (AnTI) sum score (p=<0.001). Patients with pulmonary arterial hypertension and current major depressive or panic disorder displayed significantly more dysfunctional metacognitions than those without these disorders.
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