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. 2021 Dec 17:16:3387-3396.
doi: 10.2147/COPD.S328617. eCollection 2021.

Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease in China: Results from the China Pulmonary Health [CPH] Study

Ke Huang  1   2 , Kewu Huang  3 , Jianying Xu  4 , Lan Yang  5 , Jianping Zhao  6 , Xiangyan Zhang  7 , Chunxue Bai  8 , Jian Kang  9 , Pixin Ran  10 , Huahao Shen  11 , Fuqiang Wen  12 , Yahong Chen  13 , Tieying Sun  14 , Guangliang Shan  15 , Yingxiang Lin  3 , Sinan Wu  2   16 , Ting Yang  1   2   17 , Chen Wang  1   2   17   18
Affiliations

Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease in China: Results from the China Pulmonary Health [CPH] Study

Ke Huang et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: Anxiety and depression are often underdiagnosed and affect the prognosis of patients with chronic obstructive pulmonary disease (COPD). We analyzed data from the China Pulmonary Health (CPH) study to assess the prevalence of anxiety and depression in COPD patients and their relationship with disease severity.

Patients and methods: A total of 57,779 subjects aged 20 years or older were recruited in the CPH study. All participants were assessed using a standard questionnaire and underwent pulmonary function tests before and after the use of a bronchodilator in local health centers. The Hospital Anxiety and Depression Scale (HADS) questionnaire with a cutoff score of 8 was used to define anxiety and depression. The prevalence of anxiety and depression in patients of COPD were investigated. Multivariate logistic regression was used to investigate the effects of COPD and lung function on anxiety and depression.

Results: A total of 49,053 participants (20,661 men and 28,392 women) completed the questionnaire with reliable post-bronchodilator pulmonary function test results and were included in the final analysis, of which 4686 (9.55%) were diagnosed with COPD. Of the patients with COPD, 10.79% had anxiety, 13.65% had depression, and 7.08% had anxiety and depression concomitantly. In the multivariate logistic regression analysis, COPD was not significantly associated with anxiety, depression, or both. After adjusting for confounders in model 1, patients in the GOLD III-IV group had a significantly higher risk of anxiety, depression, and their coincidence. After further adjusting for respiratory symptoms in model 2, lung function impairment in the GOLD III-IV group was only significantly associated with a higher risk of depression or at least one of anxiety and depression.

Conclusion: Anxiety and depression are prevalent in patients with COPD in China. More severe lung function impairment is significantly associated with a higher risk of depression.

Keywords: COPD; HADS; Hospital Anxiety and Depression Scale; anxiety; depression.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Prevalence of anxiety and depression in populations with COPD and non-COPD. The HADS subscale scores were used to define the severity of anxiety or depression, with a score of 8–10 denoting mild case, 11–14 moderate case and 15 or higher severe case.
Figure 2
Figure 2
Prevalence of anxiety and depression in patients with different stages of COPD. The HADS subscale scores were used to define the severity of anxiety or depression, with a score of 8–10 denoting mild case, 11–14 moderate case and 15 or higher severe case.
Figure 3
Figure 3
Coincidence of anxiety and depression in populations with COPD and non-COPD. This figure show the prevalence of subjects suffered from anxiety and depression concomitantly in COPD and non-COPD groups, as well as different GOLD stage groups.
See this image and copyright information in PMC

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