Researchers discovered that medically attended anxiety and depression manifest at a greater rate among patients with cold agglutinin disease (CAD) than among a matched cohort of individuals without the disease, according to a study published in PLOS ONE.

CAD accounts for around one-fifth of autoimmune hemolytic anemia cases in the United States. The prevalence of the condition is roughly equivalent between the sexes—1 in 300,000 people. In CAD, patients experience unpredictable occurrences of severe anemia that require emergency interventions, such as blood transfusions. 

“Patients with anemia are more likely to develop anxiety and depression that affect their quality of life, but there are no studies to date that investigate this in patients with CAD,” the authors of the study wrote.

Continue Reading

They hence set out to investigate the risk of mental health conditions such as anxiety or depression among patients with CAD. They aimed to do so using clinical and claims data on the mental health needs of patients with CAD as well as their subsequent outcomes. 

Read more about CAD etiology 

Patients were identified via Optum’s deidentified Integrated Claims-Clinical dataset from January 2006 to June 2016. 

“This data set links electronic medical record data with adjudicated claims data to provide de-identified information on medications, lab results, vital signs, body measurements, diagnoses, procedures, and clinical notes . . . for approximately 55 million patients seen throughout the United States,” the authors of the study wrote. 

Out of the 814 patients with CAD identified via this methodology, 384 met the depression and anxiety inclusion criteria. These individuals were matched with 2789 control patients without CAD. Results indicated that patients with CAD have greater healthcare utilization, including increased use of prescribed drugs or psychotherapy.

In addition, patients with CAD have a shorter time to event for any medication use, psychotherapy, or hospitalization. 

Various studies in the past have examined how mental and physical health are intricately linked. Studies have also shown that anxiety and depression may affect the general course of a disease and impact both morbidity and mortality. 

“Our study indicates that medically attended anxiety and depression manifest at a higher rate in patients with CAD than in a matched non-CAD cohort,” the authors of the study concluded. “These findings suggest that patients with CAD may experience a greater burden of disease that potentially has a broader impact on their overall mental health, physical health, and quality of life.”


Broome CM, Hooda N, Su J, et al. Medically-attended anxiety and depression is increased among newly diagnosed patients with cold agglutinin disease: analysis of an integrated claim-clinical cohort in the United StatesPLoS One. 2022;17(12):e0276617. doi:10.1371/journal.pone.0276617