Prevalence and correlations with depression, anxiety, and other features in outpatients with chronic obstructive pulmonary disease in China: a cross-sectional case control study.

Peian Lou,Jiaxi Yu,Jing Zhao,Lei Zhang,Pan Zhang,Hongmin Wu,Na Chen,Peipei Chen,Yanan Zhu,Ning Zhang

doi:10.1186/1471-2466-12-53

Abstract

BackgroundPatients with chronic obstructive pulmonary disease (COPD) often experience depression and anxiety, but little information is available regarding Chinese patients with these conditions. The present study assessed depression and anxiety in Chinese patients with COPD.MethodsA case–controlled study was designed with 1100 patients with COPD enrolled in the case group and1100 residents without COPD and respiratory symptoms selected as the control group. Anxiety and depression in both groups were evaluated using the Hospital Anxiety and Depression Scale (HADS). The body mass index,degree of airflow obstruction, dyspnea, and exercise capacity (BODE ) index was used to assess COPD severity. Binary logistic regression models were used to test the association between anxiety and depression.ResultsThe patients with COPD were more likely than controls to experience depression (cases, HADS 10.5 ± 3.6, prevalence 35.7%; controls, HADS 8.7 ± 2.7, prevalence 7.2%) and anxiety (cases, HADS 10.4 ± 3.1, prevalence 18.3%; controls, HADS 8.6 ± 2.1, prevalence 5.3%). Subjects with anxious and depressive symptoms had poorer health outcomes including a higher BODE index, a shorter 6-minute-walk distance (6MWD), more dyspnea, and a higher St George’s respiratory questionnaire (SGRQ) score. The prevalence of anxious and depressive symptoms increased with increasing BODE scores. On the basis of binary logistic regression, the BODE index was significantly correlated with anxiety (OR = 1.47, p < 0.001) and depression (OR = 1.51, p < 0.001). Anxious and depressive symptoms were also associated with several factors including younger age, female sex, higher education level, lower household income and history of smoking.ConclusionsThis study confirmed the high prevalence of anxiety and depression in Chinese outpatients with COPD. Patients with COPD who had anxiety and/or depression had a poorer health-related quality of life.Trial registrationChinese Clinical Trials Registration(ChiCTR-TRC-12001958)

Highlights

Patients with chronic obstructive pulmonary disease (COPD) often experience depression and anxiety, but little information is available regarding Chinese patients with these conditions
The presence of dyspnea had the following distribution: 160 patients (14.5%), Medical Research Council (MRC) 0; 465 (42.3%), MRC l; 355 (32.3%), MRC 2; 91(8.3%) MRC 3; and 29 (2.6%), MRC 4, with a median of 1 (P5-P95, 0–3). These patients showed a mean FEVl of 1.27 L (SD, 0.36 L), a mean 6-minute-walk distance (6MWD) of 445 m (SD, 91 m), a mean body mass index (BMI) of 23.3 k/m2 (SD, 2.8 k/m2), a mean St George’s respiratory questionnaire (SGRQ) total score of 43.4 (SD, 17.6), and a median BODE index of 2 (P5-P95, l–6)
The results showed that MRC and 6MWD were independent predictors for anxious symptoms and FEVl% and MRC were independent predictors for depressive symptoms (Table 5)

Summary

Introduction

Patients with chronic obstructive pulmonary disease (COPD) often experience depression and anxiety, but little information is available regarding Chinese patients with these conditions. The present study assessed depression and anxiety in Chinese patients with COPD. Chronic obstructive pulmonary disease (COPD) is a leading cause of disability and death worldwide, with population prevalence rates of 5–13% [1,2,3]. Increasing evidence suggests that anxiety and depression may have direct impacts on health status, hospitalization and exacerbation of COPD [11,12], rather than being consequences or markers of disease severity. The close correlation between anxiety and depression is well known, few studies have examined their simultaneous occurrence in patients with COPD.

Methods

Results

Conclusion