Hunter Montgomery
Pain is Associated with a Higher Prevalence of Depression and Anxiety in Individuals with Hemophilia and von Willebrand disease
Mentor: Ming Lim, MBBCh, MS
Department: Internal Medicine – Hematology
Individuals with hemophilia and von Willebrand disease (VWD) have higher rates of anxiety and depression than the general population. In this study, we evaluated clinical characteristics associated with depression and anxiety in individuals with hemophilia and VWD.
Data were extracted from the Utah Center for Bleeding & Clotting Disorders (UCBCD) Registry, a clinical database within EPIC. It includes accurate data of all persons with an inherited bleeding disorder seen at the UCBCD. The following data were collected: Sociodemographics, bleeding disorder diagnosis and severity, pain scores using the validated Brief Pain Inventory (BPI) tool, and depression and anxiety scores.
We conducted an ordered logistic regression analysis using PHQ-9 and GAD-7 scores as the outcome variable (n=380). Our variables of interest were: Pain Rating (BPI), Relationship Status, and insurance Status. We adjusted for age, gender identity, and language as baseline covariates in the model.
Overall, the analysis suggests a significant association between pain rating and mental health scores. Those with moderately severe to severe pain ratings were more likely to have higher PHQ-9 scores compared to those with none to mild pain ratings (OR: 5.00, 95% CI: 2.07,11.7; OR: 24.7, 95% CI: 9.93, 64.5). Those who reported severe pain ratings were more likely to have higher GAD-7 scores compared to those with none to mild pain ratings (OR: 11.4, 95% CI: 4.12, 33.6). Additionally, those who reported using Federal Insurance were more likely to have a higher GAD-7 score when compared to those using Commercial Insurance (OR: 2.40, 95% CI: 1.00, 5.65).