Across contemporary MPN studies, clinically relevant distress is commonly observed, but exact rates vary by study design, population, and the questionnaires/cutoffs used. [1,2,3]

MLR-safe phrasing: rather than stating a single prevalence number for PV, it is more defensible to state that depressive/anxiety symptoms occur in MPN care and can be clinically significant, supporting the rationale for routine screening. [2,5]

Mood symptoms in PV are usually multifactorial, including:

• • Overall symptom burden and functional impact (fatigue and sleep disruption). [3,4]
  • Psychosocial stressors related to adapting to a chronic condition (uncertainty, role changes, social limitations). [3,7]
  • Medical contributors that can mimic or worsen depressive/anxiety symptoms (e.g., sleep disorders, pain, comorbid conditions, and medication effects in general). [5,6]

Safety note: If a person develops acute confusion, hallucinations, or rapidly worsening mental status, urgent medical evaluation is appropriate to rule out medical causes and ensure safety. [5]

1. Use brief validated tools at baseline and periodically, and when symptoms change. [5,6]
2. Ask about sleep, energy, interest/pleasure, concentration, appetite, daily functioning, and safety (thoughts of self-harm). [5]
3. If screening is positive, follow with a focused clinical assessment to confirm severity and identify contributing medical and psychosocial factors. [5,6]
4. Urgent evaluation/referral is appropriate for active suicidal ideation, inability to care for self, new confusion, hallucinations, or rapidly worsening function. [5]

• Screen and track mood/anxiety symptoms over time using brief validated tools and documentation. [5,6]
• Don’t dismiss mood symptoms as “just fatigue”; consider symptom overlap and functional impact. [3,4]
• Escalate urgently for safety concerns or acute mental status change. [5]

1. Could PV itself cause my low mood?

PV may contribute to low mood for several reasons. Many people with PV (and other myeloproliferative neoplasms) report ongoing symptom burden and reduced quality of life, and psychological distress can occur alongside physical symptoms such as fatigue and sleep disruption. If low mood persists or interferes with daily life, tell your care team so it can be assessed and supported. [2,3,8]

2. Who should I contact for combined care?

Start with your hematology team and/or primary care clinician. They can assess severity, rule out contributing medical issues, and connect you with mental-health support when needed. Seek urgent help immediately if you have thoughts of self-harm, feel unsafe, develop sudden confusion, hallucinations, or cannot care for yourself. [5]

1. Gibek, K., Sacha, T., & Cyranka, K. (2023). Comparison of depressive, anxiety, and  How, C.-J., Coffey, B., Dieli-Conwright, C. M., Hobbs, G. S., Amonoo, H. L., El-Jawahri, A., & Newcomb, R. (2024, November 5). Factors associated with quality of life impairments in patients with myeloproliferative neoplasms. Blood, 144(Supplement 1), 3811. https://doi.org/10.1182/blood-2024-194829
2. Patel, R., Patel, R. V., Boselli, D., Meadors, P. L., Begley, S., Bose, R., Ai, J., Ragon, B. K., Sanikommu, S., Shah, N., Knight, T., Symanowski, J. T., Walsh, D., Mesa, R. A., Grunwald, M. R., & Chojecki, A. (2025). Distress and care utilization in patients with myeloproliferative neoplasms. Acta Haematologica, 148(6), 690–698. https://doi.org/10.1159/000544162
3. Eppingbroek, A. A. M., Lechner, L., Bakker, E. C., Nijkamp, M. D., de Witte, M. A., & Bolman, C. A. W. (2024). The personal impact of living with a myeloproliferative neoplasm. Psycho-Oncology, 33(4), e6338. https://doi.org/10.1002/pon.6338
4. Andreazzoli, F., Levy Yurkovski, I., Gowin, K., & Bonucci, M. (2025). Management of myeloproliferative neoplasms: An integrative approach. Journal of Clinical Medicine, 14(14), 5080. https://doi.org/10.3390/jcm14145080
5. Grassi, L., Caruso, R., Riba, M. B., Lloyd-Williams, M., Kissane, D., Rodin, G., McFarland, D., Campos-Ródenas, R., Zachariae, R., Santini, D., Ripamonti, C. I., & ESMO Guidelines Committee. (2023). Anxiety and depression in adult cancer patients: ESMO clinical practice guideline. ESMO Open, 8(2), 101155. https://doi.org/10.1016/j.esmoop.2023.101155
6. Gascon, B., Elman, J., Macedo, A., Leung, Y., Rodin, G., & Li, M. (2024). Two-step screening for depression and anxiety in patients with cancer: A retrospective validation study using real-world data. Current Oncology, 31(11), 6488–6501. https://doi.org/10.3390/curroncol31110481
7. Eppingbroek, A. A. M., Lechner, L., Bakker, E. C., Nijkamp, M. D., de Witte, M. A., & Bolman, C. A. W. (2025). The role of psychosocial adjustment in the quality of life of patients with myeloproliferative neoplasms. European Journal of Oncology Nursing, 76, 102855. https://doi.org/10.1016/j.ejon.2025.102855
8. Liu, Y., Zhao, J., Zhang, Q., Gao, Q., Cao, Y., He, J., Han, L., Wang, Y., Yang, Q., & Xie, W. (2025). Health distress and challenges in patients with myeloproliferative neoplasms during follow-up consultations at the outpatient clinic: A phenomenological study. Cancer Reports, 8(11), e70373. https://doi.org/10.1002/cnr2.70373