Proportion of Anxiety and Depression in Chronic Obstructive Pulmonary Disease Patients

ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable condition characterised by airflow limitation that is not fully reversible, and it has systemic consequences that include anxiety and depression. Psychiatric comorbidity is frequently unrecognised and may worsen quality of life. This study determined the proportion of anxiety and depressive disorders in COPD patients and compared their quality of life with and without these disorders. Methods: This cross-sectional observational study was conducted over six months in the Department of Medicine, Mathura Das Mathur Hospital, attached to Dr. S. N. Medical College, Jodhpur. One hundred patients with spirometry-confirmed COPD who gave informed consent were enrolled. Sociodemographic data were recorded on a structured proforma. The Hospital Anxiety and Depression Scale (HADS) was used for screening, and diagnoses were confirmed by a psychiatrist using ICD-10 criteria. Quality of life was assessed with the WHOQOL-BREF (Hindi version). Groups were compared using the chi-square test and Student's t-test. Results: Of the 100 patients, 77 were men and 23 were women. Depressive disorders were present in 27% (95% CI 19.3-36.4) and anxiety disorders in 14% (95% CI 8.5-22.1). Depression was significantly more frequent in women than in men (47.8% vs 20.8%; p=0.010), whereas anxiety was more frequent in men (16.9% vs 4.3%; p=0.128). No other sociodemographic factor was significantly associated with depression or anxiety. Patients with psychiatric comorbidity had markedly lower scores in the physical, psychological, social and environmental WHOQOL-BREF domains in both sexes (p<0.05 for all domains). Conclusion: Depression and anxiety are common in COPD patients and are associated with poorer quality of life. Routine screening for psychiatric comorbidity with a simple tool such as the HADS should be part of COPD care. Keywords: Chronic obstructive pulmonary disease; anxiety; depression; Hospital Anxiety and Depression Scale; quality of life; WHOQOL-BREF