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Allergy and Airway |

Major Depression and Anxiety Disorders in Patients With Chronic Obstructive Pulmonary Disease

Abebaw Yohannes, PhD; Thomas Willgoss
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Health Professions, Manchester Metropolitan University, Manchester, Greater Manchester, United Kingdom


Chest. 2014;146(4_MeetingAbstracts):38A. doi:10.1378/chest.1994417
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Abstract

SESSION TITLE: COPD Diagnosis and Evaluation Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Anxiety and depressive symptoms are common in patients with chronic obstructive pulmonary disease (COPD). However, the prevalence of major depression and clinical anxiety is uncertain. We examined the prevalence of major depression and anxiety disorders in COPD patients attending outpatient pulmonary rehabilitation and acute respiratory assessment service.

METHODS: 56 COPD patients agreed to participate in the study. Inclusion criteria: FEV1 < 70% predicted and Mini Mental State Examination > 23. Depression and anxiety were assessed using the Hospital Anxiety Depression Scale (HAD), health status was examined using the COPD assessment test (CAT), physical disability was evaluated using the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Patients that exhibited high level of HAD depressive or anxiety symptoms > 8 had further clinical interview using the Mini International Neuropsychiatric Interview (MINI).

RESULTS: In 56 COPD patients, the prevalence of anxiety HAD was 29 (52%) and depression HAD was 24 (43%). Out of these, 22 COPD patients (female = 16) underwent the MINI assessment. The mean (SD) age was 71.1 (5.7) years. FEV1 % predicted mean (SD) was 44.85 (18.31). Ten patients (45%) had an anxiety disorder. The most common anxiety disorders were panic disorder with or without agoraphobia 8 (36%) and generalised anxiety disorder was 5 (23%) whilst current major depression was 9 (41%). Seven (32%) patients had both a clinical anxiety disorder and a mood disorder. Major depression was related with increased physical disability [r = -0.56, p < ooo1], and clinical anxiety was associated with poorer health status [r = 0.68, p < 0.001]. Patients smoking status: current 27%, previous smoker 63% and never smoked 20%. The mean (SD) pack years was 37.63 (20.53).

CONCLUSIONS: Clinical anxiety and depression are common in patients with COPD. The most common anxiety disorders were panic disorder with or without agoraphobia and generalised anxiety disorder. Increased physical disability and impaired quality of life are associated with major depression and anxiety, respectively.

CLINICAL IMPLICATIONS: Untreated major depression and anxiety increased physical disability and impaired quality of life of patients with COPD. Clinicians should be vigilant in detection and treatment of these comorbid-disorders in patients with COPD.

DISCLOSURE: The following authors have nothing to disclose: Abebaw Yohannes, Thomas Willgoss

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