Impact of anxiety and depression on the prognosis of copd exacerbations

Abstract

Background Frequent and highly prevalent as comorbidities in Chronic Obstructive Pulmonary Disease (COPD) patients, both depression and anxiety seem to have an impact on COPD prognosis. However, they are underdiagnosed and rarely treated properly. Aim To establish the prevalence of depression and anxiety in patients admitted for Acute Exacerbation of COPD (AECOPD) and determine their influence on COPD prognosis. Methods Prospective observational study conducted from October 1, 2016 to October 1, 2018 at the following centers in Galicia, Spain: Salnés County Hospital, Arquitecto Marcide, and Clinic Hospital Complex of Santiago de Compostela. Patients admitted for AECOPD who agreed to participate and completed the anxiety and depression scale (HADS) were included in the study. Results 288 patients (46.8%) were included, mean age was 73.7 years (SD 10.9), 84.7% were male. 67.7% patients were diagnosed with probable depression, and depression was established in 41.7%; anxiety was probable in 68.2% and established in 35.4%. 60.4% of all patients showed symptoms of both anxiety and depression. Multivariate analysis relates established depression with a higher risk of late readmission (OR 2.06, 95% CI 1.28; 3.31) and a lower risk of mortality at 18 months (OR 0.57, 95% CI 0.37; 0.90). Conclusion The prevalence of anxiety and depression in COPD patients is high. Depression seems to be an independent factor for AECOPD, so early detection and a multidisciplinary approach could improve the prognosis of both entities. The study was approved by the Ethical Committee of Galicia (code 2016/460).

Temporal trends in anxiety and depression prevalence and their association with adverse outcomes in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease in Beijing, China, from 2004 to 2020

“…Therefore, there is a need for more experienced psychiatric professionals as well as a well-established system to improve future diagnosis capabilities. On the other hand, in previous studies, psychological scales such as the Hospital Anxiety and Depression Scale (HADS) and Hamilton Anxiety Rating Scale (HAMA) were used to detect AECOPD patients suffering from anxiety and/or depression ( 3 , 8 , 20 ). Accordingly, these studies reported higher prevalence of anxiety and depression than we did (ranging from 44.4 to 68.2%) ( 3 , 8 ).…”

“…Anxiety and depression are common in patients with COPD, with an estimated prevalence of 6-74% and 8-80%, respectively (2)(3)(4)(5)(6)(7). As important comorbidities in COPD, anxiety and depression are associated with increased risks of exacerbations (2,8), emergency care use (9), and medical costs (10), contributing to a substantial disease burden of COPD (6).…”

“…In the meantime, there is still controversy regarding the impact of anxiety and depression on the prognosis of patients hospitalized for AECOPD. Some authors have reported a worse disease progression (18)(19)(20), while others have failed to find any link between anxiety nor depression and a worse prognosis (8,21). More evidence from large-sample representative study is needed.…”

Correction to: Impact of anxiety and depression on the prognosis of copd exacerbations

“…Following publication of the original article [ 1 ], it was flagged that the authors' respective given and family names had been erroneously swapped in the author list. The author list has since been corrected in the published article and the correct list may be seen in this erratum.…”

Determinants of depressive symptom trajectories in self-reported chronic obstructive pulmonary disease patients

“…COPD patients commonly exhibit some level of depressive symptoms, with depressive symptoms being in 16–74% of them, and the symptoms are commonly unrecognized and thus go untreated [ 6 ]. The unrecognized depressive symptoms are a major clinical challenge as they can adversely affect physical health, quality of life, and prognosis of COPD individuals [ 7 , 8 ]. Depressive symptoms are complex and often change dynamically with the passage of time, with many patients exhibiting few or no depressive symptoms consistently, whereas a minority report persistent symptoms [ 9 ].…”