Depression and anxiety in patients with COPD

Yohannes, Abebaw Mengistu; Alexopoulos, George S.

doi:10.1183/09059180.00007813

Cited by 332 publications

(275 citation statements)

References 25 publications

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“…It is estimated that as many as 40% of patients with COPD have comorbid depression or suffer from depressive symptoms (29,30), and we found a comparable prevalence in our population. However, the percentages in our study and in the general COPD population likely underestimate the actual prevalence of depression, partly because COPD and depression share a number of overlapping symptoms such as decreased energy and fatigue (31), and the effect of COPD …”

Section: Discussionmentioning

confidence: 89%

Depression Is Associated with Readmission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

et al. 2016

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Rationale: Hospitalization for acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and health care costs, and hospitals in the United States are now penalized by the Centers for Medicare and Medicaid Services for excessive readmissions. Identifying patients at risk of readmission is important, but modifiable risk factors have not been clearly established, and the potential contributing role of psychological disease has not been examined adequately. We hypothesized that depression and anxiety would increase the risk of both short-and long-term readmissions for acute exacerbation of COPD.Objectives: To characterize the associations between depression and anxiety and COPD readmission risk. Methods:We examined the medical records for all patients with a primary diagnosis of acute exacerbation of COPD by International Classification of Diseases, Ninth Revision codes admitted to the University of Alabama at Birmingham Hospital between November 2010 and October 2012. Those who did not meet the standardized study criteria for acute exacerbation of COPD and those with other respiratory illnesses as the primary diagnosis were excluded. Comorbidities were recorded on the basis of physician documentation of the diagnosis and/or the use of medications in the electronic medical record. Multivariable regression analyses identified factors associated with readmission for acute exacerbation of COPD at 1 year and within 30 and 90 days.Measurements and Main Results: Four hundred twenty-two patients were included, with 132 readmitted in 1 year. Mean age was 64.8 6 11.7 years, and mean percent predicted FEV 1 was 48.1 6 18.7%. On univariate analysis, readmitted patients had lower percent predicted FEV 1 (44.9 6 17.3% vs. 50.2 6 19.4%; P = 0.05) and a higher frequency of depression (47.7% vs. 23.4%; P , 0.001). On multivariable analysis, 1-year readmission was independently associated with depression (adjusted odds ratio [OR], 2.67; 95% confidence interval [CI], 1.59-4.47) and in-hospital tobacco cessation counseling (adjusted OR, 0.34; 95% CI, 0.18-0.66). Depression also predicted readmission at 30 days (adjusted OR, 3.83; 95% CI, 1.84-7.96) and 90 days (adjusted OR, 2.47; 95% CI, 1.34-4.55).Conclusions: Depression is an independent risk factor for both short-and long-term readmissions for acute exacerbation of COPD and may represent a modifiable risk factor. In-hospital tobacco cessation counseling was also associated with reduced 1-year readmission.

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Section: Discussionmentioning

confidence: 89%

Depression Is Associated with Readmission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

et al. 2016

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“…Moreover, some uncontrolled factors could have influenced the level of anxiety in our study. Indeed, anxiety symptoms were associated with sleep disturbances in the elderly 51 and with mood, 52 which could have presented day-to-day variations in our subjects.…”

Section: Discussionmentioning

confidence: 99%

Influence of Ambient Music on Perceived Exertion During a Pulmonary Rehabilitation Session: A Randomized Crossover Study

et al. 2015

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BACKGROUND: Pulmonary rehabilitation is a key element in the treatment of COPD. Music has been shown to have a positive effect on parameters related to a decrease in exercise tolerance. The aim of this study was to evaluate the effect of listening to ambient music on perceived exertion during a pulmonary rehabilitation session for COPD subjects. METHODS: COPD subjects randomly performed a session of pulmonary rehabilitation with or without ambient music. Perceived exertion (Borg scales), anxiety (Hospital Anxiety and Depression Scale-Anxiety Subscale), dyspnea (visual analog scale), and cardiorespiratory parameters were compared at the end of both sessions. RESULTS: Forty-one subjects were analyzed. The characteristics of the COPD subjects were as follows: age, 70.5 ؎ 8.4 y; body mass index, 22.7 ؎ 3.9 kg/m 2 ; and FEV 1 , 38.6 ؎ 12.5 % predicted. Perceived exertion was not modified by ambient music, but anxiety was improved (P ‫؍‬ .02). Dyspnea, fatigue and cardiorespiratory parameters were not influenced by music during a typical session of the pulmonary rehabilitation program. CONCLUSIONS: This study demonstrates that perceived exertion during one pulmonary rehabilitation session was not influenced by ambient music. However, a positive effect on anxiety was observed. (ClinicalTrials.gov registration NCT01833260.)

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“…Meanwhile, in view of complex disease pathophysiology, it has been shown that there are various potential factors that could affect the physical activity and/or quality of life in patients with COPD. These factors include skeletal muscle abnormalities (24), concomitant depression/anxiety (25,26), other co-morbidities and/or exacerbations (27). In our study significant correlations (P<0.05) were found between six-minute walk distance and total SGRQ-score (r=−0.50) and its components including symptoms, activity and impacts (r=−0.36, −0.52 and −0.43 respectively).…”

Section: Discussionmentioning

confidence: 99%

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

Mirdamadi¹,

Rahimi²,

Safavi³

et al. 2016

J. Thorac. Dis.

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Background: The precise head to head relationships between Cardio-pulmonary exercise testing (CPET) parameters and patients' daily symptoms/activities and the disease social/emotional impact are less well defined. In this study, the correlation of COPD daily symptoms and quality of life [assessed by St. George's Respiratory Questionnaire (SGRQ)] and COPD severity index (BODE-index) with CPET parameters were investigated. Methods: Symptom-limited CPET was performed in 37 consecutive COPD (GOLD I-III) subjects during non-exacerbation phase. The SGRQ was also completed by each patient. Results: SGRQ-score correlated negatively with FEV1 (r=−0.49, P<0.01), predicted maximal workrate (%WR-max) (r=−0.44, P<0.01), V'O 2 /WR (r=−0.52, P<0.01) and breathing reserve (r=−0.50, P<0.01). However it did not correlate with Peak-V'O 2 % predicted (r=−0.27, P=0.10). In 20 (54.1%) subjects in which leg fatigue was the main cause for stopping the test, Peak-V'O 2 , %WR-max, HR-Reserve and Breathing reserve were higher (P=0.04, <0.01, 0.04 and <0.01 respectively) than the others. There was also a significant correlation between BODE-index and ∆VO 2 /∆WR (r=−0.64, P<0.001) and breathing-reserve (r=−0.38, P=0.018). Conclusions: The observed relationships between CPET parameter and daily subjective complaints in COPD were not strong. Those who discontinued the CPET because of leg fatigue were in the earlier stages of COPD. Significant negative correlation between ∆VO 2 /∆WR and BODE-index suggests that along with COPD progression, regardless of negative past history, other comorbidities such as cardiac/musculoskeletal problems should be sought. Although more difficult to use than other tools such as COPD Assessment Test (CAT) or COPD Clinical Questionnaire (CCQ) during routine daily practice (6), the St. George's Respiratory Questionnaire (SGRQ) is one of the most widely used self-complete measures in research for assessing patients' symptoms, activities and quality of life (7,8). Along with this subjective measurement, functional capacity in COPD could be measured by objective tools such as cardio-pulmonary exercise testing (CPET) or 6-min walk distance (6MWD) (9-11). Considering the fact that at rest physiologic variable such as pulmonary diffusing capacity for carbon monoxide (DLCO), body mass index (BMI) or even forced expiratory volume in one second (FEV1) could not solely predict exercise intolerance, CPET has been proposed as the gold standard for evaluating the exercise intolerance in patients with pulmonary diseases, including COPD (12). But the precise head to head comparisons of CPET variable with patients' daily symptoms/activities and the disease social/ emotional impact are less well defined. In one study among 129 COPD subjects with GOLD stage II and III, there was at best a weak correlation between Peak-V'O 2 (maximum oxygen uptake) % predicted and some sub-domains of health status (13). While in another study Peak-V'O 2 was to some extent a predictor of physical function (r 2 increased by 0.109) and health-related ...

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Depression and anxiety in patients with COPD

Cited by 332 publications

References 25 publications

Depression Is Associated with Readmission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Depression Is Associated with Readmission for Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Influence of Ambient Music on Perceived Exertion During a Pulmonary Rehabilitation Session: A Randomized Crossover Study

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

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