Effect of Incident Pulmonary Arterial Hypertension on Risk of Newly‐Diagnosed Mental Health Conditions

Pulmonary arterial hypertension (PAH) is a life‐limiting disease with psychosocial burden, although US population‐level estimates of incident mental health (MH) disorders remain limited. In this retrospective cohort study using Komodo Research Data (01/01/2016−03/31/2024), we evaluated the association between PAH diagnosis and risk of newly diagnosed MH conditions. Adults (≥ 18 years) with incident PAH were identified alongside a non‐PAH control group. Among patients with PAH ( N = 4005), the risks of newly diagnosed MH conditions were compared before and after the PAH diagnosis date (index date). Between‐group comparisons of newly diagnosed MH conditions post‐index used inverse probability weighting to balance PAH and non‐PAH patients. Outcomes included 12‐month cumulative incidence and hazard ratios (HRs) from Cox models for any MH condition and prespecified categories (anxiety, mood, sleep‐wake, substance use). Post‐diagnosis, the 12‐month risk of any newly diagnosed MH condition nearly doubled compared with pre‐diagnosis (48.1% vs 24.9%; HR: 2.29; p < 0.001). Post‐diagnosis risks were also higher for sleep‐wake (27.1% vs 11.5%; 2.59), anxiety‐spectrum (11.4% vs 8.4%; 1.37), mood (9.7% vs 6.0%; 1.65), and opioid use disorders (1.5% vs 0.7%; 2.07; all p < 0.05). Compared with matched controls ( N = 421,987), PAH patients had higher risks of any MH condition (39.5% vs 17.8%; HR: 2.57), anxiety (10.1% vs 6.5%; 1.58), mood (8.7% vs 5.3%; 1.68), and substance use disorders (5.2% vs 3.4%; 1.53; all p < 0.001). Adults with PAH experienced marked increases in newly diagnosed MH conditions after PAH onset and significantly higher risk than matched non‐PAH controls, supporting routine MH screening and integrated, proactive MH care in PAH management.