Disease knowledge level is a noteworthy risk factor of anxiety and depression in patients with chronic obstructive pulmonary disease: a cross-sectional study.

Qiao Zhang,Xiuqing Liao,Xiuling Wu,Changzheng Wang,Min Wan,Qianli Ma,Jiangrong Liao

doi:10.1186/1471-2466-14-92

Abstract

BackgroundRisk factors of anxiety and depression symptoms in patients with chronic obstructive pulmonary disease (COPD) have been widely researched, but most of them cannot be addressed clinically. The aim of this study was to investigate whether COPD knowledge level is a risk factor of anxiety and/or depression in COPD patients in addition to functional capacity and quality of life, and to determine the key topics of COPD knowledge.MethodsA total of 364 COPD patients from four centers were recruited into this cross-sectional survey. Subjects’ general medical information, assessments of lung function, dyspnea, quality of life, and exercise capacity, and responses to the Hospital Anxiety and Depression Scale (HAD) and the Bristol COPD Knowledge Questionnaire (BCKQ) were collected. Partial correlation analysis was performed, and a multivariable model testing risk factors of anxiety and depression as well as a multivariable model of 13 topics of knowledge derived from BCKQ were constructed.ResultsSubjects with anxiety or depression were more likely to have less COPD knowledge. Partial correlation analysis revealed that HAD score was negatively correlated with BCKQ score (rho = −0.153, P = 0.004). BCKQ score was significant in the multivariable model that tested risk factors of anxiety and depression (P = 0.001, OR = 0.944). Topics of epidemiology (P < 0.001, OR = 0.653) and infections (P = 0.006, OR = 0.721) were significant in the multivariable model evaluating 13 topics.ConclusionsThe level of patients’ disease knowledge is a significant risk factor of anxiety and depression in COPD patients. Epidemiology and infections are key topics of COPD knowledge to target in the Chinese population.Trial registrationChiCTR-OCS-12002518

Highlights

Risk factors of anxiety and depression symptoms in patients with chronic obstructive pulmonary disease (COPD) have been widely researched, but most of them cannot be addressed clinically
We have found that COPD patients with greater disease knowledge had fewer symptoms of anxiety and depression in our COPD disease management plan
We hypothesize that COPD patients’ disease knowledge is another risk factor related to anxiety and depression symptoms. In this cross-sectional study, we investigate whether COPD knowledge level is a risk factor of anxiety and depression symptoms in COPD patients alongside functional capacity and quality of life

Summary

Introduction

Risk factors of anxiety and depression symptoms in patients with chronic obstructive pulmonary disease (COPD) have been widely researched, but most of them cannot be addressed clinically. Anxiety and depression are common psychological disturbances affecting a substantial number of patients with COPD, with reported prevalence rates of 10–57% for anxiety and 10–59% for depression [1,2,3,4] Both are significantly associated with increased physical disability and morbidity, decreased health status, and decreased compliance with medical treatment [4,5,6,7,8]. Some risk factors of anxiety and depression symptoms in COPD patients have been widely researched, including younger age, female gender, current smoker status, bronchitic phenotype, more advanced disease, cardiovascular comorbidities, and worse functional capacity and quality of life [1,2,9,10]. The finding that COPD patients’ anxiety and depression symptoms improved following pulmonary rehabilitation provides a valuable clue [11,12,13]

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