Prevalence of Anxiety and Depression in Patients with Severe COPD: Similar High Levels with and without LTOT

Abstract

The benefits of long-term oxygen therapy (LTOT) on mood in Chronic Obstructive Pulmonary Disease (COPD) are unproven. Longitudinal studies are affected by disease progression, the increased package of care (with LTOT) and may not control for known confounders on mood. We compared the point prevalence and severity of mood disturbance in patients with severe COPD, not on LTOT (the -LTOT group) to those with COPD on LTOT (the +LTOT group). We mailed the Hospital Anxiety and Depression (HAD) Score to 182 consecutive patients with severe COPD, identified from respiratory case notes in three UK Hospitals. We compared 57 patients not prescribed LTOT to 57 patients on LTOT, and used stratified sampling to match the groups as far as possible for age, gender, lung function and other possible confounders on mood. Or these, 25% of patients in both groups scored in the 'definite' case range for anxiety (HAD score >or= 11). 37% of the -LTOT group and 33% of the +LTOT group scored in the 'definite' range for depression (HAD score >or= 11) (p=N.S). In both groups, only 11% of responders were prescribed anxiolytics and/or antidepressants. Further multiregression analysis confirmed that socio-demographic variables (e.g., lives alone, feels isolated or recent life events) were stronger predictors of mood than the prescription of LTOT or other traditionally accepted factors such as co-morbidity or the use of antidepressants or anxiolytics. High levels of anxiety and depression are present in severe COPD and appear under-treated. The +LTOT and -LTOT patients had a similar high prevalence of anxiety and depression.

Positive association between the plasma levels of 5-hydroxyindoleacetic acid and the severity of depression in patients with chronic obstructive pulmonary disease

“…COPD patients often have psychological disorders, including depression, and such patients tend to have more frequent exacerbations and a poor prognosis [3-7]. Recently, we demonstrated that depressed COPD patients had a lower HRQOL and more frequent exacerbations and hospitalizations those non-depressed COPD patients [3].…”

Depression, but not sleep disorder, is an independent factor affecting exacerbations and hospitalization in patients with chronic obstructive pulmonary disease

“…Difficulty in falling asleep may be a predictor for the development of depression in elderly people, including patients with COPD 7 . Patients with more severe COPD have a higher incidence of psychological disorders 10,11 . There is increasing evidence that psychological disorders may have a direct impact on HRQOL and the frequency of exacerbations and hospitalizations in patients with COPD 10–14 .…”

“…7 Patients with more severe COPD have a higher incidence of psychological disorders. 10,11 There is increasing evidence that psychological disorders may have a direct impact on HRQOL and the frequency of exacerbations and hospitalizations in patients with COPD. [10][11][12][13][14] Depression and sleep disorders may affect exacerbations, hospitalizations and mortality.…”

Major Depression in Long-Term Oxygen Therapy Dependent Chronic Obstructive Pulmonary Disease

“…There are many studies investigating the relation between COPD and depression in COPD patients with stable mild or moderate disease (van Ede et al, 1999;van Manen et al, 2002). However, few studies involving severe COPD have been reported (Kim et al, 2014;Lacasse, Rousseau, & Maltais, 2001;Lewis et al, 2007). Many studies focused on "depressive symptoms" rather than depression as a whole, while examining the relation between depression and COPD (Stage, Middelboe, Stage, & Sorensen, 2006).…”