Patients with chronic obstructive pulmonary disease (COPD) may experience an acute exacerbation of their illness if they have depression and/or anxiety, suggests a study in the Journal of Affective Disorders.
Guangxi Li, M.D., Ph.D., of Guang'anmen Hospital at the China Academy of Chinese Medical Sciences in Beijing and colleagues interviewed 504 adults with COPD who visited the pulmonary clinic at the hospital from January 2012 through July 2013. The patients completed the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) to screen for depression and anxiety symptoms. Those with an SAS score of 50 or more were considered to have anxiety. Those with an SDS score of 53 or more were considered to have depression. The researchers defined an acute exacerbation of COPD as an acute event that worsened a patient’s respiratory symptoms of COPD beyond normal day-to-day variation and led to a change in at least one of three medications such as antibiotics, corticosteroids, or bronchodilators. The researchers determined acute exacerbations from the patients’ case records from February to August 2014.
Just over 54% of patients with anxiety experienced an acute exacerbation of their COPD compared with about 40% of patients without anxiety. About 52% of patients with depression experienced an acute exacerbation of their COPD compared with slightly more than 40% of those without depression. Overall, the risk of acute exacerbation was 60% higher in patients with anxiety and/or depression.
The findings suggest that health care professionals should pay attention to symptoms of anxiety and depression in patients with COPD, as these symptoms may be associated with worse outcomes, the researchers wrote. “[L]arger multi-center prospective cohort studies [could] explore the association between anxiety and/or depression and [acute exacerbation of] COPD, in order to reduce the additional burden of disease associated with these mental stresses, as well as discover new therapies or interventions to decrease the morbidity and mortality of acute exacerbation.”
For related information, see the Psychiatric Services article “Effects of Mental Health on the Costs of Care for Chronic Illnesses.”
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