HIGH BURDEN OF DEPRESSION AND ANXIETY IN OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY: INSIGHTS FROM GERMAN CLAIMS AND CLINICAL DATA
Author(s)
Lisa-Marie Müller, MSc1, Maximilian Nicolas Möbius-Winkler, Dr. med.2, Alexander Kogel, Dr. med.2, Joscha Kandels, Dr. med.2, Marios Antoniadis, Dr. med.2, Jonas Krampe, Dr. nat.1, Ulrich Laufs, Prof. Dr. med.2, Karsten Lenk, PD Dr. med.2, Ulrike Rudolph, Dr. med.2.
1Gesundheitsforen Leipzig GmbH, Leipzig, Germany, 2Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany.
1Gesundheitsforen Leipzig GmbH, Leipzig, Germany, 2Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany.
OBJECTIVES: Obstructive hypertrophic cardiomyopathy (oHCM) is frequently accompanied by significant psychological distress. This study aimed to quantify the prevalence of depression and anxiety and identify associated socioeconomic and clinical factors in patients with oHCM.
METHODS: Two complementary analyses were performed: We analyzed statutory health insurance claims from the German Analysis Database for Evaluation and Health Services Research, comprising 4.3 million individuals (2014-2023). Multivariable logistic regression was used to identify socioeconomic, clinical, and treatment-related factors associated with depression. For validation, we retrospectively evaluated Patient Health Questionnaire-9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS) scores of 44 outpatients with oHCM treated at a tertiary care center.
RESULTS: Among 2,841 individuals with oHCM, the prevalence of depression and anxiety was 38.51% and 20.10%, respectively, both significantly higher than in an age- and gender-matched 1:10 control cohort (30.98% and 15.09%; p<0.001). Greater age (adjusted odds ratio (aOR) 2.38; 95% confidence interval 1.45-3.95), female gender (aOR 2.06; 1.88-2.26), receiving unemployment benefits (aOR 2.18; 1.69-2.81), and comorbidities associated with high symptom burden (e.g. heart failure, obstructive sleep apnea, stroke) were linked to a higher likelihood of depression, whereas treatment with beta-blockers (aOR 0.81; 0.73-0.89), calcium channel blockers (aOR 0.68; 0.58-0.79), and German nationality (aOR 0.41; 0.35-0.49) were associated with lower odds (all p<0.01). In the outpatient cohort, clinically relevant depressive symptoms were present in 25% (PHQ-9) and 36% (HADS-D), and anxiety in 20% (HADS-A).
CONCLUSIONS: Depression and anxiety are highly prevalent among patients with oHCM in Germany and are closely associated with disease severity and socioeconomic disadvantage. These findings highlight a substantial and likely underrecognized psychological burden in routine care. Integrating systematic mental health screening using validated instruments and embedding multidisciplinary care models into clinical pathways may improve patient outcomes.
METHODS: Two complementary analyses were performed: We analyzed statutory health insurance claims from the German Analysis Database for Evaluation and Health Services Research, comprising 4.3 million individuals (2014-2023). Multivariable logistic regression was used to identify socioeconomic, clinical, and treatment-related factors associated with depression. For validation, we retrospectively evaluated Patient Health Questionnaire-9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS) scores of 44 outpatients with oHCM treated at a tertiary care center.
RESULTS: Among 2,841 individuals with oHCM, the prevalence of depression and anxiety was 38.51% and 20.10%, respectively, both significantly higher than in an age- and gender-matched 1:10 control cohort (30.98% and 15.09%; p<0.001). Greater age (adjusted odds ratio (aOR) 2.38; 95% confidence interval 1.45-3.95), female gender (aOR 2.06; 1.88-2.26), receiving unemployment benefits (aOR 2.18; 1.69-2.81), and comorbidities associated with high symptom burden (e.g. heart failure, obstructive sleep apnea, stroke) were linked to a higher likelihood of depression, whereas treatment with beta-blockers (aOR 0.81; 0.73-0.89), calcium channel blockers (aOR 0.68; 0.58-0.79), and German nationality (aOR 0.41; 0.35-0.49) were associated with lower odds (all p<0.01). In the outpatient cohort, clinically relevant depressive symptoms were present in 25% (PHQ-9) and 36% (HADS-D), and anxiety in 20% (HADS-A).
CONCLUSIONS: Depression and anxiety are highly prevalent among patients with oHCM in Germany and are closely associated with disease severity and socioeconomic disadvantage. These findings highlight a substantial and likely underrecognized psychological burden in routine care. Integrating systematic mental health screening using validated instruments and embedding multidisciplinary care models into clinical pathways may improve patient outcomes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH3
Topic
Epidemiology & Public Health
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Mental Health (including addiction)