Posttraumatic stress disorder and posttraumatic stress symptoms among adults with hemophilia A and B

Amanda Stahl; Kaitlin Barnett; Amy K Wilson; Siyang Ren; Donna Neuberg; Hae Soo Park; Aric Parnes

doi:10.1016/j.rpth.2023.102241

Posttraumatic stress disorder and posttraumatic stress symptoms among adults with hemophilia A and B

Res Pract Thromb Haemost. 2023 Oct 31;7(8):102241. doi: 10.1016/j.rpth.2023.102241. eCollection 2023 Nov.

Authors

Amanda Stahl¹, Kaitlin Barnett², Amy K Wilson³, Siyang Ren⁴, Donna Neuberg⁴, Hae Soo Park¹, Aric Parnes¹

Affiliations

¹ Division of Hematology, Brigham & Women's Hospital, Boston, Massachusetts, USA.
² Icahn School of Medicine at Mount Sinai, New York, New York, USA.
³ M Health Fairview Center for Bleeding and Clotting Disorders, Minneapolis, Minnesota, USA.
⁴ Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

Abstract

Background: Persons with hemophilia may encounter various traumatic experiences related to their bleeding disorder throughout their lifetime. Little is known about the clinical impact of disease-related trauma on this population.

Objectives: To explore the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms in adults with hemophilia A and B and characterize the traumatic experiences they report.

Methods: An online survey tool collecting data on participant characteristics and a validated questionnaire containing the PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders 5 were distributed via Research Electronic Data Capture to adults with hemophilia A and B during their annual visit to their hemophilia treatment center. Participants were asked about traumatic experiences specific to their hemophilia prior to self-administering the PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders 5 questionnaire.

Results: Survey responses from 178 individuals across 3 hemophilia treatment centers were included in the analysis, representing a 70% response rate. One hundred one (56.7%) participants identified a hemophilia-related traumatic event, and 21 (11.8%) participants met criteria for a provisional diagnosis of PTSD. Multivariable analysis showed higher odds of a positive PTSD screen in participants with noninfectious (odds ratio [OR], 13.89; 95% CI, 2.23-86.62) and infectious comorbidities (OR, 11.18; 95% CI, 1.34-93.45) and in participants with >1 mental health comorbidity (OR, 10.07; 95% CI, 2.39-42.52). On the contrary, age >46 years (OR, 0.6; 95% CI, 0.01-0.62) and higher education (OR, 0.25; 95% CI, 0.07-0.88) reduced odds of PTSD.

Conclusion: Persons with hemophilia are at risk of developing PTSD and posttraumatic stress symptoms. These data support the need for trauma screening, psychosocial services in the bleeding disorders community, and provision of trauma-informed care by providers.

Keywords: adult; hemophilia; posttraumatic; prevalence; stress disorders.