Fatigue, Depression, and Anxiety in Patients with COPD, Asthma and Asthma-COPD Overlap

Abstract

Introduction. Asthma and COPD are extremely common respiratory diseases that have a serious impact on people’s lives around the world. A disease characterized by symptoms characteristic for asthma and COPD is called asthma-COPD overlap (ACO). Fatigue and certain psychological disorders such as anxiety and depression are important comorbidities in these diseases. The purpose of this study was to assess the prevalence of fatigue, anxiety, and depression in patients with asthma, COPD, and ACO and to also consider their mutual correlations. Material and Methods. A total of 325 patients were enrolled in the study. There were 159 women and 166 men and their mean age was 63. Two standardized questionnaires were used: the Modified Fatigue Impact Scale (MFIS) and the Hospital Anxiety and Depression Scale (HADS). Results. The mean total MFIS score for all patients was 33.03. Patients with asthma generally scored lower than patients with COPD and ACO. There were no statistical differences in the HADS for anxiety between the groups, although around half of the patients registered a score indicating some level of disorder. Patients with COPD and ACO were proven to suffer more from depression than patients with asthma. The HADS and MFIS scores were found to correlate significantly and positively. Conclusions. Our study showed that patients with COPD, asthma, and ACO generally suffered from an increased level of fatigue and depression. Anxiety was high in all groups, but it was at a similar level for patients suffering from each of the three diseases under consideration. It is important to treat the physical symptoms as well as the psychological disorders since they greatly impact on the patient outcomes.

Epidemiological characteristics of asthma-COPD overlap, its association with all-cause mortality, and the mediating role of depressive symptoms: evidence from NHANES 2005–2018

“…Paying attention to the mental health of ACO patients, this study found that there was a higher proportion of people suffering from depressive disorders in the ACO group than in the asthma-only group, COPD-only group, non-asthma/COPD group, and non-ACO group. Using non-ACO participants as reference, these results revealed that ACO patients might have a higher risk of experiencing depressive disorders, which were consistent with the insights given by previous studies, e.g., Homętowska et al (2022) [ 71 ] and Kang et al (2019) [ 70 ], Chabowski et al (2016) [ 72 ], and Lee et al (2021) [ 15 ]. Although the present findings did not provide definitive evidence of the causal relationship between ACO and depressive states or conclusive reasons for the elevated risks of depression in ACO patients, several factors may contribute to this association.…”

Mental health and sleep quality among patients with asthma and COPD

“…In addition, there is a close association between mental health and respiratory diseases. For instance, patients with COPD and asthma are more likely to experience anxiety and depression ( 12 , 13 ).…”

Exploring Current Concepts and Challenges in the Identification and Management of Early-Stage COPD

“…Consequently, the study of chronic respiratory symptoms in a young patient should begin by evaluating a diagnosis of asthma [ 39 ]. Additionally, the combination of the two diagnoses in a single patient constitutes a challenge for the clinician, especially at younger ages, with direct clinical consequences [ 40 , 41 ]. Yet another consideration is that few patients in this age group have been included in large clinical trials.…”