Key result
Cardiac involvement in AL amyloidosis is linked to ~29% greater anxiety and emotional role limitations.
Why the study?
Depression and anxiety in patients with AL amyloidosis and their associations with patient characteristics and cardiac involvement were not well characterized.
Cross-Sectional (n=1,226)
No
A high proportion of patients with AL amyloidosis suffer from depression and anxiety, with cardiac involvement specifically associated with increased anxiety and emotional role limitation.
Hypothesis-generating for emotional support in cardiac AL amyloidosis; prospective studies needed before practice implications.
BACKGROUND: Our study examines depression and anxiety in patients with immunoglobulin light chain (AL) amyloidosis, and determines the associations between the mental health problems and patient characteristics (age, gender, race, marital status, alcohol consumption, smoking status and cardiac involvement). METHODS: Patients with AL amyloidosis who completed the 36-item Short Form General Health Survey (SF-36) during initial evaluation at a single center were studied. The SF-36 included assessments of depression, anxiety, role limitation due to emotional problems and the mental health subscale score. RESULTS: From 1226 patients with AL amyloidosis, 37.0% reported depression and 46.7% reported anxiety. Patients with cardiac amyloidosis reported more anxiety (odds ratio (OR) = 1.29, 95% confidence interval (CI) 1.03-1.61) and role limitation due to emotional problems (OR = 1.32, 95%CI 1.05-1.65). No significant association between cardiac involvement and depression was found (OR = 1.22, 95%CI 0.97-1.54). Men reported less anxiety (OR = 0.72, 95%CI 0.57-0.91). Patients ≥65 years experienced greater role limitation (OR = 1.36, 95%CI 1.08-1.71). Smokers (p = 0.019) and women (p = 0.006) scored lower on mental health subscales. CONCLUSIONS: Many patients with AL amyloidosis suffer from depression, anxiety and functional limitations. Psychiatric assessment and treatment is important, and further research is needed to clarify the long-term effects of depression and anxiety in AL amyloidosis. This current study was registered in ClinicalTrials.gov as NCT00898235.
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Shu et al. (2016) conducted a cross-sectional in AL amyloidosis (n=1,226). Cardiac involvement vs. No cardiac involvement was evaluated on Anxiety (OR 1.29, 95% CI 1.03-1.61). Cardiac involvement in patients with AL amyloidosis was associated with increased anxiety (OR 1.29; 95% CI 1.03-1.61) and role limitation due to emotional problems (OR 1.32; 95% CI 1.05-1.65).
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