The value of COPD Assessment Test in Screening Anxiety and Depression in stable COPD patients

Abstract

Background Anxiety and depression are common comorbidities in COPD patients but are often under-diagnosed. We aimed to assess the value of the COPD Assessment Test (CAT) in identifying anxiety and depression from patients with COPD. Methods Stable COPD patients were recruited in this cross-sectional observational study between December 2016 and January 2021. The demographic characteristics and the CAT score were recorded. Anxiety was measured using Generalized Anxiety Disorder Questionnaire (GAD)-7. Depression was measured by Patient Health Questionnaire (PHQ)-9. Logistic regression analysis and receiver operating characteristic curve analysis were performed to identify factors associated with anxiety or depression and to calculate the predictive values. Results A total of 530 stable COPD patients were enrolled and of those the proportion of anxiety and depression were 17.0% and 21.5%, respectively. The CAT score correlated well with the GAD-7 score (r = 0.339, P < 0.001) and PHQ-9 score (r = 0.435, P < 0.001). The adjusted odds ratios of the CAT for the presence of anxiety and depression were 1.094 (95% CI: 1.057–1.131) and 1.143 (95% CI: 1.104–1.183), respectively. The CAT score demonstrated a good performance in identifying anxiety and depression with area under curves (AUCs) of 0.709 and 0.791, respectively. Among CAT items, analysis further showed that non-respiratory CAT components were superior to respiratory components in identifying both anxiety and depression. Conclusions The CAT score might be valuable in screening anxiety and depression in stable COPD patients. However, the screening value should be further evaluated using the diagnostic criteria for anxiety and depression in the future. Trial registration: Clinicaltrials.gov (NCT03044847); 07/02/2017.