A recent cross-sectional study published in the journal Haemophilia indicates that women with hemophilia experience higher levels of anxiety, depression, and fatigue than their male counterparts, although their pain levels, distress, and overall quality of life remain similar. The findings underscore the necessity of integrating mental health services into the care provided to women with this condition.
The research involved adults aged 18 and older with hemophilia A or B, treated at two hemophilia centers between July 2017 and December 2019. The study analyzed various outcomes, including quality of life, mental and physical health measures, and overall health, employing both unadjusted and multivariable linear regression models to explore potential sex-based differences.
Christine L. Kempton, corresponding author and a researcher at Emory University School of Medicine, expressed interest in understanding the experiences of women with hemophilia. “It was not surprising that we saw greater amounts of depression, anxiety, and fatigue; these are higher in women in the general population,” she noted. However, the study raises questions about whether these differences stem from gender, hemophilia, or the interplay between the two factors.
The cohort included 139 patients, comprising 21 women and 118 men, with a mean age of 36.9 years; 89.2% of participants had hemophilia A. Among the women, 85.7% had mild hemophilia, compared to 26.3% of men. The results revealed that women reported significantly higher depression, anxiety, and fatigue scores than men in both unadjusted and adjusted analyses, while no significant differences were found in other health outcomes.
The researchers highlighted that patient-reported outcomes can provide deeper insights into the patient experience, which may differ despite similar underlying disease states and treatment protocols. Dr. Kempton emphasized the importance of addressing mental health concerns in women with hemophilia, stating, “Even if the greater depression, anxiety, and fatigue are caused by the hemophilia, it is crucial to address these issues, as they impact each woman’s journey and how they manage their condition.”
Additionally, the study noted that men had a higher incidence of treatment with inhibitors and complications from infections such as HIV or HCV. However, no significant differences were observed between genders regarding household income, financial status, or educational attainment. Interestingly, men were more likely to be disabled (10.2% vs. 0%), but health-related quality of life scores remained similar for both genders.
The findings revealed that 20% of women reported moderate to severe depression, compared to 13.2% of men. Furthermore, 33.3% of women self-reported a depression diagnosis versus 20.2% of men, and 38.1% of women reported experiencing anxiety, in contrast to 11.4% of men. Dr. Kempton advocated for the optimization of care for women with hemophilia to include mental health resources, highlighting the need for a multidisciplinary approach.
While the study’s small sample size of women and its focus on only two treatment centers may limit its broader applicability, experts acknowledge its significance. Geoffrey Wool, MD, PhD, noted that the research provides crucial insights into the psychosocial effects of hemophilia in women, despite the limited representation.
Dr. Ankit Shah from Rutgers New Jersey Medical School praised the study for challenging the traditional male-centric perspective of hemophilia research. He urged hematologists to recognize and address the psychosocial challenges faced by women, advocating for proactive screening for depression and anxiety.
Dr. James Martin from the Cleveland Clinic commended the study’s design and conclusions, emphasizing that illness and treatment experiences differ between genders. He underscored the importance of understanding these differences and the need to care for patients holistically, addressing not just their bleeding disorders but also their mental health needs.
As the research indicates, women with hemophilia can experience clinically significant bleeding and related physical and emotional challenges. It is essential to understand their lived experiences and provide tailored support measures, thereby improving care and outcomes for this often-overlooked population.
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