J R Mehta1, I J Ratnani2, J D Dave1, B N Panchal2, A K Patel1, A U Vala2. 1. Department of Pulmonary Medicine, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India. 2. Department of Psychiatry, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.
Abstract
OBJECTIVE: This was a single-centre, cross-sectional, observational study performed at a tertiary care hospital in India to study the association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease (COPD). METHODS: A total of 59 clinically stable patients with COPD were assessed for disease severity, as per the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (2013). Psychiatric co-morbidities like anxiety disorders and depression were diagnosed by clinician-administered interview (as per the DSM-V criteria). Insomnia, anxiety disorders and depression, as well as quality of life were also assessed by self-rating scales including Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and St. George's Respiratory Questionnaire, respectively. RESULTS: Depression was the commonest psychiatric co-morbidity affecting 32.2% of individuals. Patients with depression and anxiety disorders had higher score in COPD assessment test (p = 0.02 and p = 0.004, respectively), ISI (p < 0.001 and p = 0.01, respectively), and poorer quality of life (p < 0.001 and p = 0.02, respectively) compared with those without these conditions. Patients with severe symptoms of COPD were more likely to suffer from anxiety (p = 0.001), depression (p = 0.01), insomnia (p = 0.01), and have poor quality of life (p < 0.001). Patients in the GOLD-D (i.e. those at high risk and with more symptoms) group had poorer quality of life (p = 0.004) when compared with GOLD-A (low risk and less symptoms) and GOLD-C (high risk and less symptoms) groups. CONCLUSIONS: Patients with psychiatric co-morbidities have severe symptoms of COPD and poor quality of life.
OBJECTIVE: This was a single-centre, cross-sectional, observational study performed at a tertiary care hospital in India to study the association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease (COPD). METHODS: A total of 59 clinically stable patients with COPD were assessed for disease severity, as per the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (2013). Psychiatric co-morbidities like anxiety disorders and depression were diagnosed by clinician-administered interview (as per the DSM-V criteria). Insomnia, anxiety disorders and depression, as well as quality of life were also assessed by self-rating scales including Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and St. George's Respiratory Questionnaire, respectively. RESULTS:Depression was the commonest psychiatric co-morbidity affecting 32.2% of individuals. Patients with depression and anxiety disorders had higher score in COPD assessment test (p = 0.02 and p = 0.004, respectively), ISI (p < 0.001 and p = 0.01, respectively), and poorer quality of life (p < 0.001 and p = 0.02, respectively) compared with those without these conditions. Patients with severe symptoms of COPD were more likely to suffer from anxiety (p = 0.001), depression (p = 0.01), insomnia (p = 0.01), and have poor quality of life (p < 0.001). Patients in the GOLD-D (i.e. those at high risk and with more symptoms) group had poorer quality of life (p = 0.004) when compared with GOLD-A (low risk and less symptoms) and GOLD-C (high risk and less symptoms) groups. CONCLUSIONS:Patients with psychiatric co-morbidities have severe symptoms of COPD and poor quality of life.
Entities:
Keywords:
Anxiety; Depression; Mental disorders; Pulmonary disease, chronic obstructive; Quality of life