David C Currow1, Sungwon Chang2, Helen K Reddel3, Slavica Kochovska2, Diana Ferreira4, Irina Kinchin5, Miriam Johnson6, Magnus Ekström7. 1. IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; Wolfson Palliative Care Research Centre, University of Hull, Hull, England; Australian National Palliative Clinical Studies Collaborative, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia. Electronic address: david.currow@uts.edu.au. 2. IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; Australian National Palliative Clinical Studies Collaborative, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia. 3. Woolcock Institute of Medical Research, University of Sydney, New South Wales, Australia. 4. Flinders University, Flinders Drive, Bedford Park, South Australia, Australia. 5. IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia. 6. Wolfson Palliative Care Research Centre, University of Hull, Hull, England. 7. Division of Respiratory Medicine & Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Abstract
CONTEXT: Breathlessness is associated with depression, but its relationship to anxiety or impaired function is less clear. OBJECTIVES: This study evaluated associations between chronic breathlessness and anxiety, depression, and functional status in the general population. METHODS: This cross-sectional study of consenting adults (18 years and older) used an online survey. Quota sampling (n = 3000) was used reflecting the 2016 national census for sex, age, and place of residence. Other data included Four-Item Patient Health Questionnaire for depression and anxiety, the modified Medical Research Council (mMRC) Breathlessness Scale, and the Australia-modified Karnofsky Performance Scale. Multinomial logistic regression assessed predictors. RESULTS: About 2977 respondents had all relevant scores (female 51.2%; median age 45.0 [range 18-92]). Prevalence of breathlessness (mMRC ≥2) was 2.4%, anxiety 6.0%, depression 2.7%, coexisting anxiety/depression 6.1%, and poorer functional status (Australia-modified Karnofsky Performance Scale ≤60) 1.6%. In multinomial regression, depression, anxiety, and coexisting anxiety/depression were predicted by younger age, longer duration of breathlessness, and poorer functional status. The highest proportions of people with breathlessness were found in the coexisting anxiety/depression group (10.6%) and depression only group (8.8%). Poorest function was in the coexisting anxiety/depression group with 11.6%. The relationship between poorer functional status and coexisting anxiety/depression was significant (odds ratio 0.90; 95% CI 0.89, 0.92). Adjusted odds ratio for breathlessness and depression only was 3.0 (95% CI 1.2, 7.8). CONCLUSION: Clinically important breathlessness (mMRC ≥2) was associated with depression, anxiety, and coexisting anxiety/depression. Poorer function that is associated with psychological morbidity in the general population requires further research.
CONTEXT: Breathlessness is associated with depression, but its relationship to anxiety or impaired function is less clear. OBJECTIVES: This study evaluated associations between chronic breathlessness and anxiety, depression, and functional status in the general population. METHODS: This cross-sectional study of consenting adults (18 years and older) used an online survey. Quota sampling (n = 3000) was used reflecting the 2016 national census for sex, age, and place of residence. Other data included Four-Item Patient Health Questionnaire for depression and anxiety, the modified Medical Research Council (mMRC) Breathlessness Scale, and the Australia-modified Karnofsky Performance Scale. Multinomial logistic regression assessed predictors. RESULTS: About 2977 respondents had all relevant scores (female 51.2%; median age 45.0 [range 18-92]). Prevalence of breathlessness (mMRC ≥2) was 2.4%, anxiety 6.0%, depression 2.7%, coexisting anxiety/depression 6.1%, and poorer functional status (Australia-modified Karnofsky Performance Scale ≤60) 1.6%. In multinomial regression, depression, anxiety, and coexisting anxiety/depression were predicted by younger age, longer duration of breathlessness, and poorer functional status. The highest proportions of people with breathlessness were found in the coexisting anxiety/depression group (10.6%) and depression only group (8.8%). Poorest function was in the coexisting anxiety/depression group with 11.6%. The relationship between poorer functional status and coexisting anxiety/depression was significant (odds ratio 0.90; 95% CI 0.89, 0.92). Adjusted odds ratio for breathlessness and depression only was 3.0 (95% CI 1.2, 7.8). CONCLUSION: Clinically important breathlessness (mMRC ≥2) was associated with depression, anxiety, and coexisting anxiety/depression. Poorer function that is associated with psychological morbidity in the general population requires further research.
Authors: David C Currow; Sungwon Chang; Diana Ferreira; Danny J Eckert; David Gonzalez-Chica; Nigel Stocks; Magnus Per Ekström Journal: BMJ Open Date: 2021-08-12 Impact factor: 3.006
Authors: Slavica Kochovska; David Currow; Sungwon Chang; Miriam Johnson; Diana Ferreira; Deidre Morgan; Max Olsson; Magnus Ekström Journal: BMJ Open Respir Res Date: 2022-05
Authors: David C Currow; Sungwon Chang; Magnus Ekström; Ann Hutchinson; Tim Luckett; Slavica Kochovska; Phillipa Hay; Stephen Touyz; Eleonora Dal Grande; Miriam J Johnson Journal: ERJ Open Res Date: 2021-10-11
Authors: Felix Holzinger; Sarah Oslislo; Lisa Kümpel; Rebecca Resendiz Cantu; Martin Möckel; Christoph Heintze Journal: BMC Health Serv Res Date: 2022-02-10 Impact factor: 2.655