Prevalence of anxiety and depression symptoms and their associated factors in mild COPD patients from community settings, Shanghai, China: a cross-sectional study

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is a serious disease frequently accompanied by anxiety and depression. Few studies have focused on anxiety and depression for mild COPD patients in China. This study aimed to assess the prevalence and associated factors for anxiety and depression among patients with mild COPD in urban communities.MethodsA cross-sectional survey of 275 mild COPD patients was conducted in 6 communities randomly sampled from Pudong New Area of Shanghai, China, in 2016. Data on socioeconomic factors and health conditions were acquired through a face-to-face interview as well as a physical examination. The Hospital Anxiety and Depression Scale (HAD) and EQ-5D visual analogue (EQ-5Dvas) were applied to evaluate their mental health and quality of life, respectively. Logistic regression model was used to estimate adjusted odds ratios (aORs) and their 95% confidential intervals (CI) for risk factors associated with anxiety or depression.ResultsAmong 275 subjects, 8.1% had anxiety and 13.4% had depression. Logistic regression analysis indicated that female patients were more likely to suffer from anxiety than male patients (aOR = 6.41, 95% CI:1.73-23.80). Poor health status (EQ-5Dvas score < 70) was significantly associated with increased risks of anxiety (aOR = 5.99, 95% CI: 2.13-16.82) and depression (aOR = 2.67, 95% CI: 1.29-5.52).ConclusionsThere were increased risks of anxiety and depression in mild COPD patients living in urban communities. Female sex and poor health status were significantly correlated to anxiety or depression. More interventions should be developed to reduce the risks of anxiety and depression at the early stage of COPD.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1671-5) contains supplementary material, which is available to authorized users.

Prevalence of Anxiety and Depression in Patient with Chronic Obstructive Pulmonary Disease

“…In a study by Xiao et al, it was reported that after adjustment for covariates, female patients were more likely to suffer from anxiety (aOR = 6.41, 95% CI: 1.73-23.80) than male patients. 19 Likewise, we found anxiety was associated with ethnicity (p=0.002), educational status (p=0.014), marital status (p=0.002) and occupational status (p=0.015) whereas depression was associated with marital status (p=0.001), working status (p=0.015) and smoking status (p=0.034). Balcells et al, 2010 also found that strong association between the working status and presence of anxiety.…”

Cognitive behavioural therapy (CBT) for patients with chronic lung disease and psychological comorbidities undergoing pulmonary rehabilitation

“…The reported prevalence of depression and anxiety are quite varied, depending on the population surveyed (smoking status, COPD severity) and the tools used for screening (43). For patients with stable COPD in primary care settings or respiratory clinics, the prevalence of depression varies widely from 10% to 57% (2,6), and for anxiety, prevalence ranges from 7% to 50% (2,5,6), with many of these patients being unaware of being affected by either condition (44).…”

“…Risk factors for increased rates of depression include living alone (45) and gender. Females have a higher rate of both anxiety and depression (6,(46)(47)(48), and rates of depression have shown to correlate with severity of dyspnoea as compared with males (47), although the quality of life symptoms has not (18). Increasing severity of COPD is associated with higher rates of depression and anxiety (4,9,49); for example, in patients requiring long-term oxygen, 57%…”

“…Other important risk factors for an increased rate of anxiety and depression include patients who have been hospitalised for an exacerbation of COPD or recovering from an exacerbation (11,51) and severe impairment of physical functioning (5,6,45).…”

“…The presence of psychological comorbidities among chronic obstructive pulmonary disease (COPD) is high, with prevalence ranging from 10% to 57% (2)(3)(4) for depression, and from 7% to 50% (2,5,6) for anxiety. The impact of anxiety or depression in COPD patients is well documented and has been shown to be associated with increased mortality (7)(8)(9), exacerbation rates, length of hospital stay (10)(11)(12)(13)(14)(15), and decreased quality of life and functional status (16)(17)(18).…”