Anxiety and depression among AL amyloidosis patients: the role of cardiac symptoms

Light-chain (AL) amyloidosis has the worst prognosis out of the different forms of cardiac amyloidosis, However, data are not available about the incidence of the disease-related psychological impact of AL amyloidosis in this population. In particular, no data are available about the impact of diagnosis communication or about the impact of cardiac symptom onset and severity on anxiety and depression levels among AL patients. Aim: To evaluate the role of time that has passed since the diagnosis was communicated, time that has passed since the onset of cardiac symptoms, and actual cardiac symptom severity have on level of anxiety, depression and psychological stress among cardiology patients with AL. Thirty-two AL patients with cardiac-related symptoms were administered General Health Questionnaire, State-Trait Anxiety Inventory and Centre for Epidemiological Study-Depression Scale. Clinical variables such as months gone by since diagnosis, months gone by since the onset of cardiac symptoms, and cardiac symptom severity (New York Heart Association (NYHA) class) were measured. Troponin, NT-pro BNP levels, Mayo Stage and echocardiographic characteristics were also collected. Results: According to questionnaire normative values, AL patients presented severe psychological distress, severe anxiety and clinical depression. Moreover, anxiety levels were determined by psychological distress (p < 0.001) and months gone by since the onset of cardiac symptoms (p < 0.01) while depression levels were influenced by NYHA class (p < 0.001). Conclusions: Our results suggest that there is a need to plan psychological support for these patients with consideration for the onset of cardiac symptoms and symptom severity.