Source: Annual Congress 2005 - Health status in COPD and asthma: its relevance in pulmonary rehabilitation
Disease area: Airway diseases

Abstract

Background: Symptoms of anxiety and depression are well documented in patients with COPD. Psychiatric symptoms present similarly to those of an acute exacerbation of COPD and despite contributing to hospital admissions, these symptoms may be under-recognised and poorly addressed by medical staff. Our aim was to determine the presence of anxiety and depression in our COPD Outreach population using the Hospital Anxiety and Depression (HAD) scale. Method: Data were analysed over 12 months (N=90, 48F, age=73.5y). Spirometry, HAD score, psychiatric history and medication, were recorded during clinical stability prior to discharge. Positive patients scored >/=10 in the anxiety, and/or, >/=8 in the depression components of the HAD scale. Results: Mean values are shown. Positive patients (46%, N=41, 28F, age=71y) had greater disease severity (FEV₁ 0.7L, (range 0.3-2.1L), 28% pred FEV₁) than the negative group (21F, age=76y, FEV₁0.9L(range 0.4-2.5L), 35% pred FEV₁). Hospital admissions for the positive group were double those of the negative group (2.9 vs.1.5, per patient). In the positive group, only 30% (N=12) had sought medical help for their symptoms and 15% (N=6) were on psychiatric drugs. Conclusion: Symptoms of anxiety and depression are associated with greater COPD severity and higher hospital admission rates. We have involved a Consultant Psychiatrist in our COPD Outreach team, which we believe is unique, to address the psychiatric management of positive scoring patients. We aim to assess this intervention on future hospital admission rates.

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Citations should be made in the following way:
G. Coates, C. J. Dixon, A. C. Davidson, O. S. Usmani (London, United Kingdom). The prevalence of anxiety and depression in a COPD outreach population. Eur Respir J 2005; 26: Suppl. 49, 2051

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