Abstract
Objectives: Psychological distress and adversities are more common in Chronic obstructive pulmonary disease (COPD) patients compared with other chronic illnesses. In addition, anxiety and depressive symptoms have evident impacts on COPD patients outcome. The present study designated to investigate whether anxiety and depressive symptoms occur more common in patients with severe and very severe COPD than controls. Also, we assessed the relationship between anxiety-depressive symptoms and quality of life (QOL), functional status and impairment, exacerbations, re-hospitalization, length of stay (LOS) and mortality prediction. Methods: The study sample included 220 patients with severe and very severe COPD, and 220 non-COPD patients as controls. Anxiety-depressive symptoms were assessed in COPD and controls using the Hospital Anxiety and Depression scale (HAD). The COPD group is divided into two groups: the depressed and non-depressed groups. Both groups were followed up for 12 months. Results: The prevalence of anxiety-depressive symptoms was highly significant in severe and very severe COPD patients than non-COPD patients (44.5% compared with 14.5% in controls) When the results were adjusted, the risk was 3.5 times greater for patients. Anxiety-depressive symptoms were significantly associated with more mortality, longer LOS, failure of smoking cessation and worse Saint George Respiratory Questionnaire (SGRQ). Conclusion: Anxiety-depressive symptoms occur more common in patients with severe and very severe COPD than in controls. In addition, anxiety-depressive symptoms are important risk factor for poor QOL, poor functional status and impairment, more exacerbations, more re-hospitalizations, prolonged LOS, failure of smoking quitting and more mortality. Anxiety-depressive symptoms were risk factor independent of physiological measure of disease severity (e.g. FEV1).
Highlights
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by airflow obstruction, recurrent symptoms include a cough, sputum production, breathlessness and impaired exercise tolerance [1]
Anxiety-depressive symptoms were significantly associated with more mortality, longer length of stay (LOS), failure of smoking cessation and worse Saint George Respiratory Questionnaire (SGRQ)
Anxiety-depressive symptoms occur more common in patients with severe and very severe COPD than in controls
Summary
COPD is a progressive respiratory disorder characterized by airflow obstruction, recurrent symptoms include a cough, sputum production, breathlessness and impaired exercise tolerance [1]. COPD is responsible for substantial human and economic burden throughout the world [2]. COPD was the fifth leading cause of death in 2001 [3] and is projected to be the third leading cause of death by 2020 [4]. Recent findings suggest a 5-year mortality rate following an acute exacerbation of COPD as high as 70% [5]. The association between COPD and psychiatric disorders, in particular generalized anxiety, panic anxiety and depression, has been acknowledged for many years. The prevalence of psychiatric comorbidity in these patients as well as the effect of treatment and the prognosis remains unsettled [6]
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