Influence of Thrombotic Thrombocytopenic Purpura on Depressivity, Cognitive Conduction, Quality of Life, and Resilience of Patients

Thrombotic thrombocytopenic purpura (TTP) is a potentially life-threatening, relapsing disease in which a deficiency of the enzyme ADAMTS-13 leads to generalized microvascular thrombosis in various organs. As soon as the laboratory parameters return to normal after a relapse, the patient is regarded as cured, but lives with the risk of suffering an acute relapse at any time and neurocognitive deficiencies.

To date, there have been few studies on the psychological and neurocognitive long-term effects of TTP. The present study investigated with validated questionnaires, the prevalence of depressive (PHQ-9) and anxiety symptoms (GAD-7) in 89 TTP patients, as well as parameters of subjective cognitive deficits (FLei), quality of life (QLQ-C30), attitude to life (LOT-R), and resilience (RS-11). These data were collected by standardized measuring instruments at two observation points within 1 year. At the second observation time, an age- and gender-adapted healthy control group was additionally interviewed.

It was shown that the collective of TTP patients in PHQ-9 and GAD-7 achieved significantly worse results than the healthy control group. A comparison with values from the literature also showed that TTP patients were more frequently affected by depressive episodes and anxiety disorders than the general population. In addition, many TTP patients suffer from or feel inadequate mental performance limitations. The quality of life of TTP patients is perceived as relevantly worse than that of healthy controls. This applies to both the physical and mental aspects of everyday coping. The results of the life attitude questionnaire showed that TTP patients often have lower levels of optimism than healthy controls, but not higher levels of pessimism. In addition, they have low average resilience. Regression models have been developed to determine which factors influence the presence of depressive symptoms. There was a strong positive correlation with anxiety symptoms and neurocognitive deficits. There was a negative correlation with quality of life and resilience.

Many TTP patients want more support in coping with their disease. The wish for more help from the respective family doctor was expressed particularly frequently. There is a clear need for information and treatment regarding the occurrence of affective disorders in TTP patients.

Publication History

Article published online:
13 November 2020