Depression, Anxiety and Stress among COPD Patients: A Comparative Cross Sectional Study

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is associated with depression, anxiety and stress, which are the commonest disorders resulting in significant morbidity and mortality. There is paucity of information regarding the association between depression, anxiety, and stress and chronic obstructive pulmonary disease in the present setup. This comparative cross-sectional study was designed to determine the magnitude of Depression, Anxiety and Stress and associated factors among COPD patients. Methods: Sixty five COPD patients and equal number of age and sex matched healthy individuals were included in the study. The study was conducted at Jimma University Specialized Hospital JUSH), from March 01 to April 30/2016. Spirometric assessment was done to evaluate severity of COPD. Depression, anxiety and stress scale (DASS 21) was used for the assessment of severity of depression, anxiety and stress. Chi-square test, independent t-test, Fisher’s exact test, one way ANOVA and linear regression were carried out to determine the association between independent and outcome variables and variables with p<0.05 were considered as significant. Results: Statistically significant difference between COPD patient and healthy controls was recorded on the prevalence of depression, anxiety and stress (47.7%, 49.2 %, and 56.9% respectively, p< 0.001). Depression score was significantly associated with severity of COPD (p<0.01). Duration of hospital admission was a common positive predictor for depression, anxiety and stress scores (β =0.156, 0.144 and 0.123 respectively, p<0.001), while FEV1 was a negative predictor of depression (β =-4.209) and stress score (β =-3.003), p <0.001. Higher educational level was a negative predictor of depression (β=-7.100) and anxiety scores (β = -5.15, p<0.05). Income was a negative predictor of stress score (β = -0.002, p <0.05). Cigarette smoking was a positive predictor of both depression (β=13.39, p<0.01) and anxiety scores (β=6.75, p <0.05), while khat chewing was positive predictor of only depression score (β=5.28, p<0.05). Conclusion: The present study showed that the prevalence of depression, anxiety and stress among COPD patients were significantly high. Educational status, duration of admission, FEV1, current khat chewing and cigarette smoking were predictors of depression score. At the same time educational status, cigarette smoking, history and duration of admission were predictors of anxiety score. The severity of depression, anxiety and stress was correlated with the severity of COPD. Therefore, appropriate intervention should be given by the concerned body to treat DAS among COPD patients.