Autor:innen:
Flora Caldarone, Hannover (Germany)
Philippa Gebhardt, Hannover (Germany)
Marius M. Hoeper, Hannover (Germany)
Karen M. Olsson, Hannover (Germany)
Da-Hee Park, Hannover (Germany)
Tanja Meltendorf, Hannover (Germany)
Manuel J. Richter, Gießen (Germany)
Henning Gall, Gießen (Germany)
Hossein Ardeschir Ghofrani, Gießen (Germany)
Kai G. Kahl, Hannover (Germany)
Ivo Heitland, Hannover (Germany)
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 underlying mechanisms determine their development and could therefore be targeted in preventive or therapeutic interventions. Here, we assessed metacognitions, i.e. one’s beliefs and assumptions about thinking, worrying and threat monitoring, in a sample of PAH patients with and without MDD and PD. Moreover, we reconstructed the course of mental illnesses after the PAH diagnosis.
Methods: 217 PAH patients from two German referral centers were included in this cross sectional study. The prevalence of adjustment disorder was assessed retrospectively using DSM-V criteria, and current mental disorders were assessed using the structured clinical interview for DSM-V. Additionally, metacognitive beliefs were assessed using established questionnaires (Metacognitions Questionnaire-30 [MCQ-30]; Anxious Thoughts Inventory [AnTI]).
Results: Patients with AD following the PAH diagnosis more frequently developed MDD (37.5%. 13.9%, p < 0.001) and PD (26.3% vs. 8.8%, p = 0.001) compared to PAH patients without former AD. Moreover, patients with current MDD/PD displayed more dysfunctional metacognitions than currently healthy individuals (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 = 0.002).
Conclusion: Our results suggest that maladaptive metacognitions are associated with the development and maintenance of frequent mental illnesses, particularly MDD and PD, in the context of PAH. Therefore, a metacognitive approach to treat and prevent those mental illnesses seems promising and should be investigated in future studies.