Symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation

Abstract

Chronic obstructive pulmonary disease (COPD) patients may suffer from symptoms of anxiety and depression. Whether and to what extent symptoms of anxiety and depression may be present in COPD patients entering pulmonary rehabilitation and which patient characteristics are associated with psychological distress remains currently unknown. The objective of the present study is to determine the prevalence and the determinants of clinically relevant symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation. Symptoms of anxiety and depression have been assessed in 701 COPD patients entering pulmonary rehabilitation using the Hospital Anxiety and Depression Scale. Additionally, disease-specific health status, pulmonary function, body composition, exercise capacity, co-existing morbidities, smoking status, symptoms, long-term oxygen therapy and the use of antidepressant and anxiolytic drugs have been recorded. Patients had mean anxiety scores of 7.6 points and mean depression scores of 7.2 points. Anxiety scores >or=10 points were present in 225 patients (32%) and depression scores >or=10 points were present in 192 patients (27%). Patients at risk of having symptoms of anxiety were female or used antidepressant or anxiolytic drugs. Patients at risk of having symptoms of depression experienced dyspnea, had a body mass index (BMI) <21 kg/m(2) or used antidepressant or anxiolytic drugs. A considerable proportion of the COPD patients entering pulmonary rehabilitation report symptoms of anxiety and/or depression, which may significantly impair disease-specific health status. Patients at risk of having symptoms of anxiety and/or depression are female, experience dyspnea, have a low BMI or use antidepressant and/or anxiolytic drugs.

Anxiety and Depression Among Chronic Obstructive Pulmonary Disease Patients in A Tertiary Care Hospital, Nepal

“…One of the other study from the neighbouring country India from similar (OPD) settings to the current study reported a high proportion of COPD patients having both anxiety and depression (43%) 13 . Result from the current study is however, similar to one of the earlier studies among COPD patients entering pulmonary rehabilitation in the Netherlands where 32% of participants had anxiety and 27% had depression 14 and a similar proportion of COPD patients in a study from England had anxiety (33%) and slightly lower proportion had depression (21%) 15 16 and its proportion was also shown to be signifi cantly higher among COPD individuals (25%) against the controls (12%) as seen in a systematic review and meta-analysis of more than 39000 individuals each 17 .…”

Impact of symptoms of anxiety and depression on COPD Assessment Test scores

“…This frequency is comparable to previous findings [1,2]. Antidepressants were more widely used than anxiolytics in our data.…”

“…Psychological screening for anxiety and depression could have enlightened these findings, as a HADS score of o10 points indicates the presence of symptoms of anxiety and depression but does not necessarily indicate a disorder [7]. JANSSEN et al [1] identified a higher proportion of patients with clinically relevant symptoms of anxiety and depression in GOLD stage IV compared to patients in GOLD I and II. Recently, LEE et al [10] reported a significantly higher proportion of patients with depression in GOLD groups B and D compared to GOLD groups A and C and concluded that ''the frequency of depression differed by current symptoms, but not by the severity of the airway limitation.''…”

Differences in content and organisational aspects of pulmonary rehabilitation programmes

“…This is somewhat surprising, as individuals with chronic respiratory disease can be very complex and need an integrated approach. Indeed, individuals with a chronic respiratory disease may present with multiple extrapulmonary features and comorbidities, such as symptoms of anxiety and depression, body composition abnormalities, cognitive dysfunction, lower-limb muscle weakness, cardiovascular disease and problematic activities of daily life [31][32][33][34][35]. These extrapulmonary features and comorbidities as well as poor self-management skills also need to be addressed during a comprehensive pulmonary rehabilitation programme [36,37].…”