Evaluation of the frequency of anxiety and depression in children with pulmonary hypertension

Purpose: Pulmonary Hypertension is a disease that severely limits life and has a high mortality rate. Weakness, shortness of breath and decrease in exercise capacity, which are present in most patients at the initial stage of the disease, become more evident as the severity of the disease increases. This situation has a great impact on the emotional, psychological, social, financial and spiritual states of both patients and their relatives. Many studies in the literature show that the frequency of anxiety and depression increases in PD patients. This study aimed to investigate anxiety and depression levels and emotional and behavioral problems (aggression, social problems, etc.) in children with pulmonary hypertension. Materials and Methods: The study was conducted with patients aged 6-18 years who applied to the Pediatric Cardiology Polyclinic of Dicle University Faculty of Medicine Hospital between 01.07.2022 and 01.12.2023. Down syndrome, aged between 6 and 18, who are being followed up in our outpatient clinic due to pulmonary hypertension. 50 patients without the syndrome were included in the study. In addition, 50 control groups, aged 6-18 years old, who did not have a chronic disease and applied to the pediatric general polyclinic of Dicle University Faculty of Medicine Hospital, were selected. A behavioral assessment scale for children and young people aged 6-18 was applied to both patients and the control group. The survey results were evaluated together with a child psychiatrist. Findings: The average age of the patient group was 168.44±48.70 months, 26 (52%) were boys and 24 (48%) were girls. The average age of the control group was 152.86±50.32 months, 32 (64%) were girls and 18 (36%) were boys. There was no difference between the control group and the patient group in terms of gender, age and body mass index (p>0.05). 90% of the patient group had an underlying congenital heart disease. The most common is VSD (ventricular septal defect). In the patient group, anxiety / depression, disobeying the rules, aggressive behavior, social problems, thought problems, attention problems, somatic complaints, internalization, externalization, obsessive compulsive disorder, post-traumatic stress disorder, mood disorder, anxiety disorder, somatization disorder, Attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder were statistically significantly more common. A positive correlation was detected between ALT value v and attention problems in the patient group (r=0.315, p=0.026). A negative correlation was observed between MCV value and aggressive behavior in the patient group (r=-0.303, p=0.033). In the patient group, anxiety /depression (r=-0.401, p=0.004), social introversion/depression (r=-0.372, p=0.008), attention problems (r=- 0.297, p=0.036), somatic complaints (A negative correlation was detected between r:0.361, p:0.010) and internalizing (r=-0.475, p<0.001). A positive correlation was observed between BUN value and internalizing in the patient group (r=0.297, p=0.036). In the patient group, a negative correlation was observed between potassium value and social introversion /depression (r=-0.311, p=0.028) and internalization (r=-0.351, p=0.013). Again, in the patient group, there was a negative correlation between calcium and social introversion/depression (r=-0.384, p=0.006). It was detected. In the patient group, no relationship was detected between oxygen saturation, BNP and PVR, PVR/SVR, oPAP values obtained from echocardiography and angiography data. Conclusion: In our study with children with pulmonary hypertension, anxiety /depression, rule-breaking, aggressive behavior, social problems, thought problems, attention problems, somatic complaints, internalization, externalization, obsessive symptoms were more common in the patient group than in the control group. Compulsive disorder, post-traumatic stress disorder, mood disorder, anxiety disorder, somatization disorder, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder were statistically significantly more common. In the patient group, a negative correlation was detected between platelet count and anxiety /depression, social introversion/depression, attention problems, somatic complaints and internalization. In the patient group, oxygen saturation, BNP, PVR, PVR/SVR and oPAP values obtained from echocardiography and angiography data were compared with the behavioral assessment scale. However, no relationship could be detected. Since such studies are insufficient in the pediatric age group, more studies are needed to support our findings. Key Words: Pulmonary hypertension, Anxiety, Depression, Child