Anxiety and Depression Among Chronic Obstructive Pulmonary Disease Patients in A Tertiary Care Hospital, Nepal

Abstract

Background: Psychiatric co-morbidities such as anxiety and depression among patients with chronic obstructive pulmonary disease exacerbate the disease, prolong the hospital stay, increase the disease symptoms and deter the quality of life. Objective: To assess the proportion of anxiety or depression among patients with chronic obstructive pulmonary disease in a tertiary care hospital. Methodology: We carried out a cross sectional study interviewing 307 patients from a tertiary care hospital using sequential sampling technique. We used structured questionnaire and included hospital anxiety and depression scale to measure anxiety and depression. We considered a summed score of 11 on each of the subscale as a case-ness of anxiety and/or depression. We present the results as proportion and adjusted odds ratio with 95% confi dence interval. Results: We found 31% of the patients as having anxiety and 35% having depression, with 19% of co-morbidity. We found higher odds of anxiety among certain groups: female (adjusted odds ratio -1.93, 95%CI: 1.10-3.39), participants visiting doctor or health facility to manage their fi rst episode of illness (adjusted odds ratio -2.56, 95%CI: 1.35-4.87). Also, the latter group had higher odds (adjusted odds ratio -3.57, 95%CI: 1.54-8.29) of co-morbid anxiety and depression. Conclusion: We found a substantial proportion of participants with case-ness of anxiety and depression. Psy chiatric evaluation and additional management of these associated comorbidities could make the management of chronic obstructive pulmonary disease comprehensive and would improve quality of life of such patients.