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Overview of the Impact of Depression and Anxiety in Chronic Obstructive Pulmonary Disease

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Abstract

Background

Anxiety and depression are common entities in patients diagnosed with COPD. However, the impact that they have on the exacerbation of illness is scarcely studied.

Objective

To determine if the presence of anxiety and depression is associated with a greater risk of frequent exacerbation (≥2 per year) in patients diagnosed with COPD.

Patients and Methods

A cohort study that analysed frequent exacerbation and associated factors in 512 patients monitored during 2 years. Exacerbations were defined as events that required antibiotic/s and/or systemic corticosteroids (moderate) or hospitalization (serious). Variables of interest were recorded for each patient, including anxiety and depression (Hospital Anxiety and Depression Scale), and we analysed their association with frequent exacerbation through the adjusted odds ratio (aOR) by means of a logistic regression model.

Results

The prevalence of anxiety/depression at the start of the study was of 15.6%. During the 2 years of monitoring, 77.9% of the patients suffered at least moderate-to-severe exacerbation. 54.1% were frequent exacerbators. Anxiety/depression were strongly associated with moderate–severe frequent exacerbation in the crude analysis (ORc = 2.28). In the multivariate analysis, the risk factors also associated with frequent exacerbation were being overweight (aOR 2.78); obesity (aOR 3.02); diabetes (aOR 2.56) and the associated comorbidity (BODEx) (ORa = 1.45).

Conclusions

The prevalence of anxiety/depression in COPD patients is high, and they are relevant risk factors in frequent exacerbation although the effect is lower in the multivariate analysis when adjusting for different variables strongly associated with exacerbation.

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Authors and Affiliations

  1. Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain

    Josep Montserrat-Capdevila, Pere Godoy, Ferran Barbé, Josep Pifarré & Miquel Alsedà

  2. Health Department, Public Health Agency of Catalonia, Avda Rovira Roure, 2, 25006, Lleida, Catalonia, Spain

    Josep Montserrat-Capdevila, Pere Godoy & Miquel Alsedà

  3. Catalan Institute of Health (ICS), Consultori local de Bellvís (ABS Pla d’Urgell), c/ Major, 19, 25142, Bellvís, Catalonia, Spain

    Josep Montserrat-Capdevila

  4. Faculty of Medicine, University of Lleida, c/ de Montserrat Roig, 2, 25008, Lleida, Catalonia, Spain

    Pere Godoy, Josep Pifarré & Miquel Alsedà

  5. Primary Care Research Institute (IDIAP) Jordi Gol, Universitat Autònoma of Barcelona, Avda de Rambla Ferran, 44, 25007, Lleida, Catalonia, Spain

    Josep Ramon Marsal

  6. Epidemiology Unit, Cardiovascular Department, University Hospital Vall d’Hebron, Passeig de la Vall d’Hebron, 119–129, 08035, Barcelona, Catalonia, Spain

    Josep Ramon Marsal

  7. University Hospital Arnau de Vilanova, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain

    Ferran Barbé

  8. Respiratory Diseases Group, Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain

    Ferran Barbé

  9. Biomedical Research Centre/Respiratory Diseases Network (CIBERES), Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain

    Ferran Barbé

  10. Psychiatry Department, University Hospital Santa Maria, Avda Rovira Roure, 44, 25198, Lleida, Catalonia, Spain

    Josep Pifarré

  11. Primary Care Research Institute (IDIAP) Jordi Gol, Catalan Institute of Health (ICS), Avda de Rambla Ferran, 44, 25007, Lleida, Catalonia, Spain

    Marta Ortega

Authors
  1. Josep Montserrat-Capdevila
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  2. Pere Godoy
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  3. Josep Ramon Marsal
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  4. Ferran Barbé
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  7. Marta Ortega
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Corresponding author

Correspondence to Josep Montserrat-Capdevila.

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Conflict of interest

The study was approved by the Clinical Research Ethics Committee of the Primary Care Research Institute (IDIAP) Jordi Gol (P14/022) Barcelona.

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Montserrat-Capdevila, J., Godoy, P., Marsal, J.R. et al. Overview of the Impact of Depression and Anxiety in Chronic Obstructive Pulmonary Disease. Lung 195, 77–85 (2017). https://doi.org/10.1007/s00408-016-9966-0

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  • DOI: https://doi.org/10.1007/s00408-016-9966-0

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