| Objective:To investigate the incidence and influencing factors of anxiety and depression in patients with classic MPN patients,and to analyze the relationship between the occurrence of anxiety and depression disorder and each symptom variable of MPN10,and to provide guidance and data support for clinical workers on health education and diagnosis and treatment of these patients.Methods:The sociodemographic characteristics,clinical data and laboratory test results of 201MPN patients attending the Department of Hematology,Second Hospital of Shanxi Medical University from October 2014 to February 2023 were collected to understand the incidence of anxiety and depressive disorder in MPN patients,and the influencing factors and the relationship with each symptom variable of MPN10 were retrospectively analyzed.Results:(1)Incidence of anxiety or depression disorders in MPN patients:59(29.35%)met the screening criteria for HADS(HADS≥11),50(24.88%)met the screening criteria for the anxiety subscale(HADS-A≥8)and 25(12.44%)met the screening criteria for the depression subscale(HADS-D≥8),with anxiety disorders occurring most frequently in ET patients(25/90,27.78%),followed by patients with PV(13/53,24.5%)and lowest in patients with MF(12/58,20.69%).Depressive disorders occurred highest in MF patients(8/58,13.79%),followed by ET patients(11/90,12.22%)and lowest in PV patients(6/53,11.32%),but none of the differences between anxiety-depressive disorders and disease type were statistically significant.(2)Factors influencing MPN patients with anxiety disorders:compared to men,a higher proportion of women had anxiety disorders(16.49%vs 32.69%,χ~2=7.046,p=0.008);compared to younger people,a lower proportion of older people had anxiety disorders(47.92%vs 4.76%,χ~2=23.057,p<0.001);a higher proportion of people with basic education had anxiety disorders compared to those with compared to those with higher education(33.66%vs 10.26%,χ~2=9.518,p=0.009);and compared to those with income expenditure balances,those with lower economic status were more likely to have anxiety disorders(5.41%vs 39.33%,χ~2=19.733,p<0.001).patients with higher MPN10scores were more likely to have anxiety disorders(16.80±1.38 vs 6.66±0.55,t=7.550,p=0.007).In contrast,there was no statistically significant difference between splenomegaly,previous history of thrombosis,duration of disease,type of disease,driver genes,white blood cell count,haemoglobin and platelet count and anxiety disorders(p>0.05).(3)Factors affecting MPN patients with depressive disorders:compared to younger people,older people had a lower proportion of depressive disorders(25.00%vs 0.00%,χ~2=12.957,p=0.002);compared to average income levels,people with poorer economic status were more likely to have depressive disorders(5.41%vs19.10%,χ~2=6.665,p=0.036).Patients with higher MPN10 scores were prone to depressive disorders(19.48±2.19 vs 7.73±0.56,t=2.689,p<0.001).In contrast,gender,education level,household registration,splenomegaly,previous history of thrombosis,duration of disease,type of disease,driver gene,white blood cell count,haemoglobin and platelet count were not statistically significant differences with depressive disorders(p>0.05).(4)Binary logistic regression analysis showed that age≥70 years(HR=0.923,95%CI:0.887-0.960,p<0.001;HR=0.939,95%CI:0.899-0.980,p=0.004)had a lower risk of anxiety and depressive disorder.The higher the MPN10 score(HR=1.147,95%CI:1.078-1.221,p<0.001;HR=1.119,95%CI:1.055-1.187,p<0.001)and the higher the risk of developing anxiety and depressive disorder.(5)Relationship between MPN10 scores and anxiety and depressive disorder:All symptom load variable scores were associated with anxiety and depressive disorder except fever,and the higher the MPN10 score,the heavier the symptom load and the greater the negative impact on daily life and work(p<0.001).Spearman correlation analysis showed that MPN10 scores were positively associated with anxiety and depressive disorder.In MF and ET patients,there was a strong correlation between anxiety and/or depressive disorders(HADS scale),anxiety disorders(HADS-A subscale)and depressive disorders(HADS-D subscale)and MPN10 scores(r>0.6,p<0.001).In patients with PV,there was a moderate correlation(r>0.4,p<0.001)between anxiety and/or depressive disorders(HADS scale),anxiety disorders(HADS-A subscale)and depressive disorders(HADS-D subscale)and MPN10 scores.The MPN-10 score was higher in patients with depressive disorder than in patients with anxiety disorder(19.48±2.19 vs 16.80±1.38,t=0.012,p=0.285),but the difference was not statistically significant.Conclusions:(1)Anxiety and depressive disorder is a highly prevalent mood disorder in patients with MPN,anxiety disorders are more prevalent than depressive disorders,and somatic symptom load is higher in patients with depressive disorders than in patients with anxiety disorders.(2)Anxiety and depressive disorders are associated with sociodemographic factors(e.g.age,economic situation,etc)and somatic symptom load.It is independent of disease type,disease duration,driver genes,previous thrombosis,splenomegaly,white blood cell count,hemoglobin,or platelet count.(3)MPN10 score was positively correlated with anxiety and depressive disorder.The higher the MPN10 score,the heavier the symptom load and the greater the negative impact on daily life and work;Anxiety and depression disorders will increase the burden of physical symptoms of patients.(4)Monitoring MPN10 score can predict the occurrence of anxiety and depression disorder early,which has important guiding significance for clinical work diagnosis and treatment and patient education. |
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