Depression and anxiety in patients with AL amyloidosis as assessed by the SF-36 questionnaire: experience in 1226 patients^#

Abstract

Background: Our study examines depression and anxiety in patients with immunoglobulin light chain (AL) amyloidosis, and determines the associations between the mental health problems and patient characteristics (age, gender, race, marital status, alcohol consumption, smoking status and cardiac involvement).

Methods: Patients with AL amyloidosis who completed the 36-item Short Form General Health Survey (SF-36) during initial evaluation at a single center were studied. The SF-36 included assessments of depression, anxiety, role limitation due to emotional problems and the mental health subscale score.

Results: From 1226 patients with AL amyloidosis, 37.0% reported depression and 46.7% reported anxiety. Patients with cardiac amyloidosis reported more anxiety (odds ratio (OR) = 1.29, 95% confidence interval (CI) 1.03–1.61) and role limitation due to emotional problems (OR = 1.32, 95%CI 1.05–1.65). No significant association between cardiac involvement and depression was found (OR = 1.22, 95%CI 0.97–1.54). Men reported less anxiety (OR = 0.72, 95%CI 0.57–0.91). Patients  ≥65 years experienced greater role limitation (OR = 1.36, 95%CI 1.08–1.71). Smokers (p = 0.019) and women (p = 0.006) scored lower on mental health subscales.

Conclusions: Many patients with AL amyloidosis suffer from depression, anxiety and functional limitations. Psychiatric assessment and treatment is important, and further research is needed to clarify the long-term effects of depression and anxiety in AL amyloidosis.

This current study was registered in ClinicalTrials.gov as NCT00898235.

• AL amyloidosis
• anxiety
• depression
• mental health
• SF-36

Acknowledgements

We gratefully acknowledge our colleagues in the Amyloidosis Center, Cancer Clinical Trials Office and Center for Cancer and Blood Disorders at Boston Medical Center who assisted with the multidisciplinary evaluation and treatment of the patients, and particularly the patients themselves who participated in this research study. We thank Michelle K. White, PhD, Sr. Scientist and Sr. Director of Consulting Operations at QualityMetric, Now Part of Optum for critical review of the manuscript.

Declaration of interest

The authors report no conflicts of interest.