Anxiety and depression in COPD patients and correlation with sputum and BAL cytology

Abstract


 
 
 Background and aims: Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD). The degree of lung function may not explain anxiety and depression. The aim of our study was to assess the psycholog- ical aspects of COPD, to test the BODE index (a composite score of body mass, obstruction, dyspnea and exercise capac- ity), and to evaluate the association between atypical cyto- logic findings of sputum, bronchoalveolar lavage (BAL) and the pyschological components of the disease.
 Methods: COPD was classsified according to the GOLD stages based on forced expiratory volume in 1 second (FEV1) in 60 stable patients. The BODE index was calculated for grading COPD. The Hospital anxiety and depression (HAD) scale was used to appraise the anxiety and depression symptoms. Cytologic examination of sputum and BAL samples were per- formed in each patient. The cytologic findings were classified as normal, mild, moderate or severe atypia.
 Results: The overall prevalance of anxiety and depression symptoms was 41.7% and 46.7% respectively. The prevalance of these symptoms increased with increasing BODE stages and correlated well with the severity of atypical BAL cytology results (p < 0.001). Dyspnea and reduced exercise capacity were the predominant mechanisms leading to anxiety and depression symptoms associated with COPD.
 Conclusions: We conclude that the BODE index is superior to GOLD stratification for explaining anxiety and depression symptoms in COPD. BAL cytologic findings, which reflect the distal parenchymal lung structure, correlated significantly with the presence of the anxiety and depression symptoms.
 
 

The value of COPD Assessment Test in Screening Anxiety and Depression in stable COPD patients

“…Some previous studies identi ed impaired lung function (FEV 1 or GOLD severity) as a risk factor for depression [12,21,39]. However, other studies showed that FEV 1 %predicted was not independently associated with depression after adjusting for factors including respiratory symptoms and patient-reported outcomes [9,10,[40][41][42]. Our results showed that the relationship between lung function and clinical depression is relatively weak, FEV 1 %predicted was not associated with anxiety or depression after adjusting for CAT score and other confounders.…”

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

“…7 Untreated and undetected anxiety and depressive symptoms may increase physical disability, morbidity, and health-care utilization. 8 While few published studies demonstrate that these disorders associated with COPD respond well to appropriate pharmacologic and non-pharmacologic therapy, only a small proportion of COPD patients with these disorders receive effective treatment. 7,9 Anxiety and depression are challenging to identify and treat because their symptoms often overlap with those of COPD.…”

Mental health and quality of life among patients with chronic respiratory failure on domiciliary oxygen: a prospective cohort study from a tertiary care centre in India

“…Patients' worsening anxiety and depression could be related to poor physical health, concerns about imminent death, persistent dyspnoea, severe functional limitation, dependency and burden on family members, and reduced exercise capacity. 18 19 Bueno et al found that LTOT in elderly patients is associated with poor self-image and leads to sadness and discouragement. 20 In a similar study, Hill et al showed that anxiety's prevalence is unrelated to using domiciliary oxygen.…”