Association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease

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.

Keywords: Anxiety; Depression; Mental disorders; Pulmonary disease, chronic obstructive; Quality of life.