DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160786

Factors associated with anxiety and depression in chronic obstructive pulmonary disease

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

Abstract


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.

 


Keywords


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

Full Text:

PDF

References


Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Available at www.goldcopd.com. Accessed on 12th November 2015.

Vo¨gele C, von Leupoldt A. Mental disorders in chronic obstructive pulmonary disease (COPD). Respir Med. 2008;102(5):764-73.

Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of depression in a large urban south Indian population: the Chennai Urban Rural Epidemiology Study (Cures-70). PLoS ONE. 2009;4(9):e7185.

Abbas WSM, Mobarak H, Azmi SA, Abbas RSA, Zuber A, Sabahat Z. Assessment of anxiety and depression in COPD patients-A pilot study. Current Neurobiology. 2012;3(2):112-6.

Hill K, Geist R, Goldstein RS, Lacasse Y. Anxiety and depression in end-stage COPD. Eur Respir J. 2008;31(3):667-77.

Maurer J, Rebbapragada V, Borson S, Goldstein R, Kunik ME, Yohannes AM, et al. ACCP Workshop Panel on Anxiety and Depression in COPD. Anxiety and depression in COPD: current understanding, unanswered questions, and research needs. Chest. 2008;134(4 Suppl):43S-56S.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361-70.

Snaith RP. The Hospital Anxiety And Depression Scale. Health and quality of life outcomes. 2003;1(1):29.

Celli BR, Cote CG, Marin JM, Casanova C, de Oca MM, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350:1005-12.

Solano JP, Gomes B, Higginson IJ. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage. 2006;31:58-69.

Negi H, Sarkar M, Raval AD, Pandey K, Das P. Presence of depression & its risk factors in patients with chronic obstructive pulmonary disease. Indian J Med Res. 2014;139(3):402-8.

Ryu YJ, Chun EM, Lee JH, Chang JH. Prevalence of depression and anxiety in outpatients with chronic airway lung disease. Korean J Intern Med. 2010;25(1):51-7.

Kaneda R, Senjyu H, Iguchi A, Hayashi Y, Iwai S, Tsuda T, et al. Factors that impact anxiety and depression in patients with chronic obstructive pulmonary disease. J Phys Ther Sci. 2011;23:927-31.

De S. Prevalence of depression in stable chronic obstructive pulmonary disease. Indian J Chest Dis Allied Sci. 2011;53(1):35-9.

Wise RA. Chapter 42, Chronic Obstructive Pulmonary Disease: Clinical Course and Management. In : Fishman’s Pulmonary Diseases and Disorders. 4th ed. The McGraw-Hill Companies; 2008 :732.