The rate of child maltreatment is higher among patients with pulmonary arterial hypertension (PAH) compared to the general population, a new study published in Frontiers in Psychiatry found. Child maltreatment was also shown to have a significant impact on the severity of the disease, and there was a correlation between the level of child maltreatment and patients’ mental health and quality of life.

“With wide ranges of long-term consequences of child maltreatment, screening for a history of child maltreatment can help physicians in assessment of patients’ needs and treatment options,” the researchers wrote. “Integrating past experiences and psychological problems in the care and treatment of patients with PAH is recommended.”

It is known that child maltreatment is associated with a risk of psychological problems and long-lasting effects on a person’s mental health and quality of life. However, the prevalence or effect of child maltreatment on patients with PAH has not previously been examined.

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In the present study, a team of researchers led by Jan Fuge, MD, from the Department of Respiratory Medicine at Hannover Medical School in Germany conducted a cross-sectional, observational, multicenter study at 2 centers and calculated the prevalence of child maltreatment among 270 patients with PAH and determined its impact on the severity of the disease.

The researchers used the Childhood Trauma Questionnaire (CTQ) to assess child maltreatment. They also assessed patients’ quality of life, anxiety, depression, and lifestyle factors. Finally, they assessed disease severity using the 6-Minute Walk Distance, World Health Organization functional class, and serum levels of NT-proBNP.

The results showed that patients with PAH had higher rates of emotional abuse compared to the general German population. However, they had lower rates of physical neglect. In terms of emotional neglect and physical and sexual abuse, there was no difference between patients with PAH and the general population.

Patients who were subjected to any form of child maltreatment were more likely to be active smokers and had a worse quality of life, and more anxiety or depression, the researchers also found. Moreover, there were moderate associations between child maltreatment, mental health, quality of life, lifestyle factors, and clinical disease parameters.

Finally, the total CTQ score had a significant impact on the severity of PAH. Child maltreatment should be taken into account when assessing the impact of mental disorders and quality of life on PAH, the researchers concluded.


Park DH, Tanja Meltendorf T, Kahl KG, et al. Childhood trauma in patients with PAH—prevalence, impact on QoL, and mental health—A preliminary report. Front Psychiatry. Published online February 10, 2022. doi:10.3389/fpsyt.2022.812862