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Updated: Jul 13, 2025

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Psychological Burden Among Patients With Inherited Bleeding Disorders in Madinah Province, Saudi Arabia
Mohammed A Zolaly1, Ali H Alshawi2, Idris A Binsari2
1Hematology and Oncology, Taibah University, Al-Madinah al-Munawwarah, SAU.
Insights
Hereditary bleeding disorders like hemophilia and von Willebrand disease (VWD) are linked to significant depression, anxiety, and stress (DAS) in Saudi Arabia. Older patients (over 15) showed higher depression rates, highlighting the need for psychological support.
Area of Science:
- Hematology
- Psychiatry
- Public Health
Background:
- Hereditary bleeding disorders (hemophilia, von Willebrand disease) impact physical and psychological health.
- Complications like depression, anxiety, and stress (DAS) can worsen patient outcomes.
- Limited prevalence data exists for DAS in these patients, particularly in Saudi Arabia.
Purpose of the Study:
- To determine the prevalence of DAS among patients with hereditary bleeding disorders in Madinah province, Saudi Arabia.
- To identify associated risk factors for DAS in this patient population.
Main Methods:
- Cross-sectional study utilizing telephonic interviews.
- Inclusion of patients diagnosed with severe hemophilia A, B, or VWD (age >10).
- Validated Depression Anxiety Stress Scale-21 (DASS-21) questionnaire used for data collection.
Main Results:
- Prevalence rates: 25% depression, 45.5% anxiety, 29.5% stress.
- Symptom severity: 9.1% extremely severe depression, 15.9% moderate anxiety, 13.6% moderate stress.
- Higher depression rates observed in patients over 15 years (42.9% vs. 8.7%, p=0.009).
Conclusions:
- Patients with inherited bleeding disorders, especially those over 15, experience significant psychological distress.
- Enhanced awareness, screening, and counseling are crucial for improving adherence and quality of life.
- A national study and integration of psychological services in Saudi Arabia are recommended.
Abstract:
Introduction Hereditary bleeding disorders, such as hemophilia and von Willebrand disease (VWD), result from specific deficiencies or malformations in the coagulation cascade proteins. These disorders can significantly impact both physical and psychological health. Complications such as depression, anxiety, and stress (DAS) can further exacerbate these impacts. Despite their significance, detailed prevalence data remain limited, especially for regions such as Madinah province in Saudi Arabia. This study aimed to determine the prevalence of DAS and their associated risk factors among patients with hereditary bleeding disorders in Madinah province, Saudi Arabia. Methods We conducted a cross-sectional study using telephonic interviews involving patients diagnosed with severe hemophilia A or B or VWD attending a hematology clinic in Madinah. Patients over 10 were included, and the study excluded those with central nervous system insults and platelet count concerns. The validated and reliable Depression Anxiety Stress Scale-21-item questionnaire and Statistical Product and Service Solutions (SPSS), version 26.0 (IBM SPSS Statistics for Windows, Armonk, NY), facilitated data collection and analysis, respectively. Results Of the 44 patients studied, 25% exhibited symptoms of depression, 45.5% showed signs of anxiety, and 29.5% had stress symptoms. Regarding symptom severity, 9.1% of patients experienced extremely severe depression, 15.9% had moderate anxiety, and 13.6% reported moderate stress. The prevalence of these psychological issues varied with patients' age and economic status. Notably, a significantly higher rate of depression was observed in patients over 15 years (42.9% vs. 8.7%; p=0.009). Additionally, while not statistically significant, patients with a high economic status reported increased rates of DAS. Conclusions Patients with inherited bleeding disorders, particularly those older than 15, manifest significant psychological distress. There is a pressing need for enhanced awareness, specialized screenings, and tailored counseling services to improve treatment adherence and overall quality of life. Given the findings, a comprehensive national study in Saudi Arabia is highly recommended, alongside the integration of specialized psychological services.
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