Anxiety among Egyptian patients with stable chronic obstructive pulmonary disease and its effect on their functional assessment

Abstract

Context Anxiety disorders are underestimated comorbid conditions in patients with chronic obstructive pulmonary disease (COPD). The Global Initiative for Chronic Obstructive Lung Disease (GOLD; updated 2019) has given wide importance on assessment of underdiagnosed comorbid conditions to evaluate patients with stable COPD. Aims To investigate the occurrence of anxiety as a hidden comorbid disease among patients with stable COPD and their effect on 6-min walk distance (6MWD) and COPD assessment test (CAT) score. Settings and design This is a descriptive cross-sectional study. Patients and methods Patients with COPD who were attending the outpatient chest clinic for follow-up at Ain Shams University Hospitals were included in the study during the period between January 2019 and July 2019. Patients were classified according to GOLD criteria 2019. The validated questionnaire for anxiety (State Trait Anxiety Inventory) was fulfilled. The patients were functionally assessed by 6MWD and CAT score. Statistical analysis Statistical Package for Social Sciences program software, version 18.0, was used for statistical analysis. Results Anxiety among Patients with COPD was 54.5%. The lower the forced expiratory volume in the first second % predicted, the greater the anxiety (P=0.027). A positive significant correlation was found between anxiety state and GOLD staging (P=0.042). 6MWD showed a statistically significant negative correlation with the degree of anxiety (P=0.018). CAT scoring had an apparent positive correlation with the anxiety state but unfortunately did not reach the statistically significant difference (P=0.081). Conclusion The underestimated comorbid anxiety disorders are found to be common in patients with COPD. It adds to patients’ dyspnea, especially with high CAT scores and decreased exercise tolerance.