Severity of Depressive Symptoms is Associated with Venous Thromboembolism in Hospitalized Patients with a Major Depressive Episode

Abstract

Kazuhisa Yoshizawa,1 Masahiro Takeshima,2 Sayaka Ishino,3 Masaya Ogasawara,2 Dai Fujiwara,2 Yu Itoh,2 Aya Imanishi,2 Hidenobu Ohta,2 Kazuo Mishima2 1Department of Psychiatry, Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Daisen City, Akita, 019-2492, Japan; 2Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita City, Akita, 010-8543, Japan; 3Department of Neuropsychiatry, Sugawara Hospital, Yurihonjo City, Akita, 015-0012, JapanCorrespondence: Masahiro TakeshimaDepartment of Neuropsychiatry, Akita University Graduate School of Medicine, 1-1-1, Hondo, Akita City, Akita, 010-8543, JapanTel [phone]Fax [phone]Email [email protected]: A major depressive episode is a risk factor for venous thromboembolism (VTE) in psychiatric inpatients. However, it is unclear whether the severity of depressive symptoms or duration of the current depressive episode is associated with VTE. Further, the VTE prevalence among hospitalized patients with a major depressive episode receiving electroconvulsive therapy is unknown. This retrospective study examined factors associated with VTE among hospitalized patients with a major depressive episode and estimated the prevalence of VTE in such patients who underwent electroconvulsive therapy.Patients and Methods: Patients with a major depressive episode hospitalized in the Department of Neuropsychiatry at Akita University Hospital between January 2018 and December 2020 were included. Data from the first week of hospitalization were extracted from medical records. VTE was diagnosed based on the findings of computed tomography. To evaluate whether the severity of depressive symptoms or duration of the current depressive episode was associated with VTE, logistic regression analysis was conducted after adjusting for covariates with known VTE risk factors (antidepressants, antipsychotics, and physical comorbidities).Results: We analyzed 133 patients; of these, 14 were diagnosed with asymptomatic VTE. The severity of depressive symptoms (odds ratio: 1.220, 95% confidence interval: 1.081– 1.377, p = 0.001) was significantly associated with VTE. The prevalence of VTE among those receiving electroconvulsive therapy was 35% (7/20).Conclusion: The prevalence of VTE was 35% among patients receiving in-hospital electroconvulsive therapy for a major depressive episode. VTE should be considered for hospitalized patients with severe depressive symptoms and patients receiving in-hospital electroconvulsive therapy for a major depressive episode.Keywords: bipolar depression, depressive symptoms, electroconvulsive therapy, unipolar depression, venous thromboembolism

Keywords

• bipolar depression
• depressive symptoms
• electroconvulsive therapy
• unipolar depression
• venous thromboembolism