Prevalence of Anxiety and Depression in Patient with Chronic Obstructive Pulmonary Disease

B Gorkhali,S Neupane,Sita Sharma,U Shakya

doi:10.3126/nmcj.v20i4.25139

Abstract

Anxiety and depression are very common comorbidities in patients with chronic obstructive pulmonary disease (COPD). This study was aimed at documenting the prevalence anxiety and depression in COPD patient attending tertiary level hospital. A quantitative cross sectional analytical study was carried out in 221 patients with previously diagnosed COPD. Participants were recruited from respiratory OPD at Tribhuvan University Teaching Hospital, Nepal. Anxiety and depression were screened using previously validated Nepalese version of Hospital Anxiety and Depression Scale (HADS) and dyspnea was assessed using the modified Medical Research Council Dyspnea Scale (mMRC). COPD Assessment Test (CAT) was used to measure the impact of COPD on daily life. Data was analyzed using SPSS version 16. Out of 221, 140 patients (63.3%) had anxiety and 153 patients (69.2%) had depression and 133 (60.2%) had both psychiatric symptoms. Factors associated with anxiety and depression in COPD patients were age, ethnicity, educational status, marital status, current working status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, domiciliary oxygen therapy comorbidities along with dyspnea, CAT score. In conclusion, the study findings suggest that anxiety and depression are highly prevalent in COPD patients.

Highlights

Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema; the airflow obstruction is generally progressive, may be accompanied by airway hyperactivity, and may be partially reversible.[1]
The mean Hospital Anxiety and Depression Scale (HADS) (±SD) anxiety score was 11.37 (± 6.894) and mean HADS (±SD) depression score was 11.18 (± 6.013). This finding is nearly consistent with the findings of the study including 60 COPD patients which show the mean scores for anxiety and depression were 8.2 ± 4.6 and 7.9 ± 4.3 respectively
We found anxiety was associated with ethnicity (p=0.002), educational status (p=0.014), marital status (p=0.002) and occupational status (p=0.015) whereas depression was associated with marital status (p=0.001), working status (p=0.015) and smoking status (p=0.034)

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema; the airflow obstruction is generally progressive, may be accompanied by airway hyperactivity, and may be partially reversible.[1] Globally around 65 million people are reported to suffer from moderate to severe COPD. Psychological status is independently related to all dimensions of health-related quality of life. Anxiety and depression are very common comorbidities in COPD and have significant impact on patients, their families, society, and the course of the disease.[4,5,6] Estimates of prevalence of anxiety and depression in COPD are generally higher than those reported in some other advanced chronic diseases. Screening for depression and anxiety may help to identify patients with poor quality of life and an urgent need for intervention in order to improve their health status.[7]

Objectives

Methods

Findings

Conclusion