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. 2022 Apr 14:13:812812.
doi: 10.3389/fpsyt.2022.812812. eCollection 2022.

Metacognitions in Patients With Frequent Mental Disorders After Diagnosis of Pulmonary Arterial Hypertension

Flora Caldarone  1 , Philippa Gebhardt  1 , Marius M Hoeper  2   3 , Karen M Olsson  2   3 , Jan Fuge  2   3 , Da-Hee Park  2   3 , Tanja Meltendorf  1   2 , Jan C Kamp  2   3 , Britta Stapel  1 , Manuel J Richter  4 , Henning Gall  4 , Hossein A Ghofrani  4   5 , Kai G Kahl  1 , Ivo Heitland  1
Affiliations

Metacognitions in Patients With Frequent Mental Disorders After Diagnosis of Pulmonary Arterial Hypertension

Flora Caldarone et al. Front Psychiatry. .

Abstract

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.

Keywords: adjustment disorder; depressive disorder; metacognitions; panic disorder; psychocardiology; pulmonary arterial hypertension (PAH); pulmonary hypertension.

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Conflict of interest statement

KO has received fees for lectures and/or consultations from Actelion, Janssen, MSD, Bayer, United Therapeutics, GSK, Janssen, Pfizer, and Acceleron, all outside the present study. HAG has received personal fees from Actelion, personal fees from AstraZeneca, personal fees from Bayer, personal fees from BMS, personal fees from GSK, personal fees from Janssen-Cilag, personal fees from Lilly, personal fees from MSD, personal fees from Novartis, personal fees from OMT, personal fees from Pfizer, and personal fees from United Therapeutics, outside the submitted work. HAG has received fees from Actelion, Bayer, Gilead, GSK, MSD, Pfizer, and United Therapeutics, outside the present work. D-HP has received honoraria for lectures from Janssen-Cilag. MH has received honoraria for lectures and/or consultations from Acceleron, Actelion, Bayer, GSK, Janssen, MSD, and Pfizer, all outside the present study. KK has received honoraria for consultations and/or lectures from Eli Lilly, Janssen, Lundbeck, Neuraxpharm, Otsuka, Pfizer, Servier, Schwabe, Takeda, and Trommsdorff/Ferrer, Alexio and CannaXan (advisory board). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Mean sum scores of the AnTI (A) and MCQ-30 (B) in patients with and without both previous AD and current MDD/PD. Depicted are two significant main effects for the factors current MDD/PD and previous AD (A) and one significant main effect for the factor current MDD/PD (B). Error bar indicate ±1 standard error of the mean. **p < 0.001; *p < 0.01.
See this image and copyright information in PMC

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