{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:28:24Z","timestamp":1788452904859,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with haemophilia (PwH) often suffer from psychological symptoms such as depression or anxiety. To date, uncertainty exists about the determinants predicting worse psychological outcomes. Therefore, this study aimed to investigate the extent of depressive, anxiety and stress\u2010related symptoms in PwH compared to the healthy population and determine the impact of disease\u2010specific and arthropathy\u2010related parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Levels of depression, anxiety, stress and overall emotional distress were queried in a total of 379 PwH and 271 healthy controls by handing out the Depression, Anxiety and Stress Scale 21. In addition, disease\u2010specific variables (e.g., type, severity, viral infections), pain intensity (NRS from 0 to 10), pain persistence (Likert\u2010scale from 1 to 6), pain sensitivity (pressure pain thresholds [PPT]) and the orthopaedic joint score (Haemophilia Joint Health Score v2.1; HJHS) were assessed to analyse associations with psychological symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PwH had higher scores for depression, anxiety, stress and overall emotional distress compared to the healthy cohort. Regarding disease\u2010specific outcomes, only PwH with hepatitis or HIV showed higher scores for depression (hepatitis,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.020), stress (hepatitis,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005; HIV,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.048) and overall emotional distress (hepatitis,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.020). Spearman's rank correlation further revealed significant associations between NRS, pain persistence, PPT and HJHS with all psychological outcomes, though most effect sizes were weak.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results provide further evidence for a poorer psychological profile in PwH compared to the healthy population. Particularly, pain\u2010related outcomes, but also joint degeneration and the presence of viral infections, are related to enhanced psychological symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70079","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T13:42:56Z","timestamp":1751031776000},"page":"884-892","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Factors Influencing Symptoms of Depression, Anxiety and Stress in Patients With Haemophilia"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5577-7306","authenticated-orcid":false,"given":"Alexander","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1738-4891","authenticated-orcid":false,"given":"Fabian","family":"Tomschi","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-5389","authenticated-orcid":false,"given":"Pia","family":"M\u00f6llers","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1325-0510","authenticated-orcid":false,"given":"Marius","family":"Br\u00fchl","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"},{"name":"Department of Orthopaedics and Trauma Surgery University Hospital Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich","family":"Richter","sequence":"additional","affiliation":[{"name":"Haemophilia Centre Muenster  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1585-4100","authenticated-orcid":false,"given":"Johannes","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Institute for Experimental Haematology and Transfusion Medicine University Hospital Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7777-3253","authenticated-orcid":false,"given":"Andreas Christian","family":"Strauss","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery University Hospital Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0935-2526","authenticated-orcid":false,"given":"Thomas","family":"Hilberg","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine University of Wuppertal  Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2019.05.011"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15444"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13960"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14571"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1639501"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(96)70431-6"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2020.06.002"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2022.18"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101556"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13548"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13214"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12644"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","unstructured":"S. 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