Published: 2016-12-28

Factors associated with anxiety and depression in chronic obstructive pulmonary disease

Ajo K. Jose, Davis P. Chelangara, Shaji K. S.


Background: COPD is a progressive condition with significant co morbidities and extra pulmonary manifestations. It is well known that anxiety and depression are the major psychiatric comorbidities associated with COPD. However, little is known about the factors associated with these conditions.  

Methods: A cross sectional observational study was performed, including 320 patients who satisfied the inclusion criteria. They were interviewed as part of the study. Anxiety and depression were screened using hospital anxiety depression rating scale (HADS). All patients were subjected for clinical examination, pulmonary function tests and routine blood examination.

Results: We found that 59.4% of COPD patients had either anxiety or depression as co morbidity and 32.2% had both the psychiatric symptoms. 166 patients (51.9%) had anxiety and 127 patients (39.7%) had depression. The factors associated with anxiety and depression in COPD patients were hospitalization (in-patients), duration of disease, number of hospitalizations in the previous year, hypertension, MMRC grade, BMI, oxygen saturation, six minute walk distance, FEV1, FVC and BODE score.  Linear regression analysis showed that the number of hospital admissions in the previous year was the most significant factor associated with both anxiety (p=0.008) and depression (p=0.020).

Conclusions: The number of hospital admissions in the previous year was the most significant factor associated with anxiety and depression in COPD.



COPD, Anxiety and depression, HADS, Forced expiratory volume (1st second), Hospital admissions

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