PURPOSE: Bronchiectasis is a frequent respiratory disease. Independently of etiology, patients usually have a progressive disease marked by recurrent exacerbations, high purulent sputum production, social and health related quality of life (HRQoL) impairment. The aim of this study is to evaluate anxiety and depression symptoms as well as HRQoL in a bronchiectasis Brazilian population, comparing cystic fibrosis (CF) and non-cystic fibrosis (non-CF) patients.
METHODS: We prospectively included adult patients with computed tomographic documented bronchiectasis and regular follow up at a tertiary institution. Hospital anxiety and depression scale (HADS) and the St. George Respiratory Questionnaire (SGRQ) were applied to evaluate anxiety/depression symptoms and HRQoL respectively.
RESULTS: Sixty-seven individuals were included, 16 CF and 51 non-CF bronchiectasis (43.8% vs. 64.7% women). Mean age was 27.9 years-old for CF and 46.1 for non-CF patients. Most of them are not regular students (95.2%) nor working (59.4%), with no significant difference between CF and non-CF patients. Mean FEV1 % predicted was 40% for CF and 46% for non-CF bronchiectasis. There was no difference regarding hospitalization in the last year and digital O2 pulse level. When analyzing HADS, we found that 25.0% CF and 41.2% non-CF showed elevated levels of anxiety symptoms and 12.5% CF and 28.4% non-CF showed elevated levels of depressive symptoms. CF patients presented lower mean SGRQ total values, although not statistical significant (45.0% vs. 58.8% - p=0.073). When analyzing each SGRQ component, CF patients still had lower values with significant difference only in the activity domain (54.7% vs. 72.4% - p=0.001).
CONCLUSIONS: Bronchiectasis has a high prevalence of anxiety and depression symptoms. Non-CF patients seem to be more impaired in all quality of life domains, especially in activity function.
CLINICAL IMPLICATIONS: CF is a disease with well-established treatment guidelines and, in our country, with a well-structured health care program which guarantee drug supply and medical assistance. This is not always available to other bronchiectasis patients. This disparity in health access and the younger profile of CF patients may justify our findings.
DISCLOSURE: The following authors have nothing to disclose: Samia Rached, Rodrigo Athanazio, Luciene Angelini, Juliana Prieto, Alberto Cukier, Regina Carvalho-Pinto, Rafael Stelmach
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