VTE may cause mental health problems

Sad woman

Photo by Jiri Hodan

DUBROVNIK, CROATIA—Results of a large study suggest patients who develop a venous thromboembolism (VTE) may have more mental health problems than their healthy peers.

One in 5 patients in the study purchased psychotropic drugs within 5 years of developing a VTE, a rate that was more than double that of age- and sex-matched control subjects.

Anette Arbjerg Højen, of Aalborg University Hospital in Denmark, presented these findings at EuroHeartCare 2015 (abstract 22).

“We know that other chronic medical illnesses in youth can lead to emotional and behavioral problems,” Arbjerg Højen said. “However, until now, VTE has been considered an acute condition that occurs in older people. There is no follow-up of [young VTE] patients regarding their mental health, and no studies have been done on this issue.”

So she and her colleagues investigated the mental health prognosis of young VTE patients using data from 4 nationwide registries: the Danish Civil Registration System, the Danish National Patient Register, the Danish National Prescription Registry, and the Danish Medical Birth Registry.

The investigators identified 4132 patients, ages 13 to 33, who had a first VTE between 1997 and 2010. The team then matched these patients by sex and birth year to a control group of 19,292 people without VTE.

All study participants were followed for their first purchase of psychotropic drugs, including antidepressants, anti-anxiety medications, sedatives, and antipsychotics.

The researchers used the purchase of psychotropic drugs as a proxy measure for mental health status and compared the measure between the two groups. The team used regression analysis to exclude non-VTE-related causes of psychotropic drug purchase, such as postpartum depression.

Results showed the VTE patients were much more likely to purchase psychotropic drugs than control subjects. Among VTE patients, the risk of purchasing psychotropic drugs following their diagnosis was 7.1% after 1 year and 22.1% after 5 years.

The excess risk for VTE patients relative to the controls was 4.7% after 1 year and 10.8% after 5 years. When the investigators adjusted for the effect of recent pregnancy or recent provocations, the risk differences became 4.1% after 1 year and 9.6% after 5 years.

“Most of the drugs prescribed were antidepressants,” Arbjerg Højen said. “These young patients struggle a lot with the fear of VTE recurrence. They are scared that, if it strikes again, it could become a pulmonary embolism and they might die.”

“Our study only included patients who received a prescription for psychotropic drugs. There will be others who were not prescribed medication because of their young age, so the group with mental health problems could be much larger than what we found.”

“Our study looked at mental health up to 5 years and not just in the immediate period after the VTE event, suggesting that it is not just a short-term panic. We don’t know how long mental health problems in VTE patients last, but we do know that these patients will always be at high risk of recurrent VTE, so there is a possibility that their depression or anxiety could be life-long if untreated.”

“Most young VTE patients are monitored by their general practitioner for 3 to 6 months because they are on oral anticoagulant treatment, but, after that, there is generally no long-term follow up. Our study points to the need for treating VTE as a chronic condition with serious mental health consequences requiring specialist care.”

Sad woman

Photo by Jiri Hodan

DUBROVNIK, CROATIA—Results of a large study suggest patients who develop a venous thromboembolism (VTE) may have more mental health problems than their healthy peers.

One in 5 patients in the study purchased psychotropic drugs within 5 years of developing a VTE, a rate that was more than double that of age- and sex-matched control subjects.

Anette Arbjerg Højen, of Aalborg University Hospital in Denmark, presented these findings at EuroHeartCare 2015 (abstract 22).

“We know that other chronic medical illnesses in youth can lead to emotional and behavioral problems,” Arbjerg Højen said. “However, until now, VTE has been considered an acute condition that occurs in older people. There is no follow-up of [young VTE] patients regarding their mental health, and no studies have been done on this issue.”

So she and her colleagues investigated the mental health prognosis of young VTE patients using data from 4 nationwide registries: the Danish Civil Registration System, the Danish National Patient Register, the Danish National Prescription Registry, and the Danish Medical Birth Registry.

The investigators identified 4132 patients, ages 13 to 33, who had a first VTE between 1997 and 2010. The team then matched these patients by sex and birth year to a control group of 19,292 people without VTE.

All study participants were followed for their first purchase of psychotropic drugs, including antidepressants, anti-anxiety medications, sedatives, and antipsychotics.

The researchers used the purchase of psychotropic drugs as a proxy measure for mental health status and compared the measure between the two groups. The team used regression analysis to exclude non-VTE-related causes of psychotropic drug purchase, such as postpartum depression.

Results showed the VTE patients were much more likely to purchase psychotropic drugs than control subjects. Among VTE patients, the risk of purchasing psychotropic drugs following their diagnosis was 7.1% after 1 year and 22.1% after 5 years.

The excess risk for VTE patients relative to the controls was 4.7% after 1 year and 10.8% after 5 years. When the investigators adjusted for the effect of recent pregnancy or recent provocations, the risk differences became 4.1% after 1 year and 9.6% after 5 years.

“Most of the drugs prescribed were antidepressants,” Arbjerg Højen said. “These young patients struggle a lot with the fear of VTE recurrence. They are scared that, if it strikes again, it could become a pulmonary embolism and they might die.”

“Our study only included patients who received a prescription for psychotropic drugs. There will be others who were not prescribed medication because of their young age, so the group with mental health problems could be much larger than what we found.”

“Our study looked at mental health up to 5 years and not just in the immediate period after the VTE event, suggesting that it is not just a short-term panic. We don’t know how long mental health problems in VTE patients last, but we do know that these patients will always be at high risk of recurrent VTE, so there is a possibility that their depression or anxiety could be life-long if untreated.”

“Most young VTE patients are monitored by their general practitioner for 3 to 6 months because they are on oral anticoagulant treatment, but, after that, there is generally no long-term follow up. Our study points to the need for treating VTE as a chronic condition with serious mental health consequences requiring specialist care.”

Sad woman

Photo by Jiri Hodan

DUBROVNIK, CROATIA—Results of a large study suggest patients who develop a venous thromboembolism (VTE) may have more mental health problems than their healthy peers.

One in 5 patients in the study purchased psychotropic drugs within 5 years of developing a VTE, a rate that was more than double that of age- and sex-matched control subjects.

Anette Arbjerg Højen, of Aalborg University Hospital in Denmark, presented these findings at EuroHeartCare 2015 (abstract 22).

“We know that other chronic medical illnesses in youth can lead to emotional and behavioral problems,” Arbjerg Højen said. “However, until now, VTE has been considered an acute condition that occurs in older people. There is no follow-up of [young VTE] patients regarding their mental health, and no studies have been done on this issue.”

So she and her colleagues investigated the mental health prognosis of young VTE patients using data from 4 nationwide registries: the Danish Civil Registration System, the Danish National Patient Register, the Danish National Prescription Registry, and the Danish Medical Birth Registry.

The investigators identified 4132 patients, ages 13 to 33, who had a first VTE between 1997 and 2010. The team then matched these patients by sex and birth year to a control group of 19,292 people without VTE.

All study participants were followed for their first purchase of psychotropic drugs, including antidepressants, anti-anxiety medications, sedatives, and antipsychotics.

The researchers used the purchase of psychotropic drugs as a proxy measure for mental health status and compared the measure between the two groups. The team used regression analysis to exclude non-VTE-related causes of psychotropic drug purchase, such as postpartum depression.

Results showed the VTE patients were much more likely to purchase psychotropic drugs than control subjects. Among VTE patients, the risk of purchasing psychotropic drugs following their diagnosis was 7.1% after 1 year and 22.1% after 5 years.

The excess risk for VTE patients relative to the controls was 4.7% after 1 year and 10.8% after 5 years. When the investigators adjusted for the effect of recent pregnancy or recent provocations, the risk differences became 4.1% after 1 year and 9.6% after 5 years.

“Most of the drugs prescribed were antidepressants,” Arbjerg Højen said. “These young patients struggle a lot with the fear of VTE recurrence. They are scared that, if it strikes again, it could become a pulmonary embolism and they might die.”

“Our study only included patients who received a prescription for psychotropic drugs. There will be others who were not prescribed medication because of their young age, so the group with mental health problems could be much larger than what we found.”

“Our study looked at mental health up to 5 years and not just in the immediate period after the VTE event, suggesting that it is not just a short-term panic. We don’t know how long mental health problems in VTE patients last, but we do know that these patients will always be at high risk of recurrent VTE, so there is a possibility that their depression or anxiety could be life-long if untreated.”

“Most young VTE patients are monitored by their general practitioner for 3 to 6 months because they are on oral anticoagulant treatment, but, after that, there is generally no long-term follow up. Our study points to the need for treating VTE as a chronic condition with serious mental health consequences requiring specialist care.”