Association between Psychological Status and Dyspnea in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Background: Dyspnea together with anxiety and depression are the most common and important comorbidities in patients with chronic obstructive pulmonary disease. Anxiety and depression can potentiate the intensity of dyspnea in this population. The current study was aimed to investigate the psychological status and perceived level of dyspnea in COPD patients. Methods: A cross sectional analytical study was carried out among 221 COPD patients at respiratory outpatient department of Tribhuvan University Teaching Hospital (TUTH), Nepal. Patients’ psychological status was assessed using a validated Hospital Anxiety and Depression Scale (HADS) and dyspnea was assessed using the modified Medical Research Council Dyspnea Scale (mMRC). Results: Out of 221 patients, 54.5% patients had symptoms suggestive of anxiety (HADS-A Score ≥11) and 51.6% patients reported symptoms suggestive of depression (HADS-D Score ≥11). Similarly, 92.8% patients reported some degree of dyspnea. Data showed that there was strong positive correlation of dyspnea with anxiety (r=0.75, p<0.001) and depression (r=0.79, p<0.001). Conclusion: The results from this study concludes that anxiety, depression and dyspnea are common symptom in COPD, and there was a positive correlation of psychological status and perceived level of dyspnea. Psychological status is therefore an important factor to consider when treating patients with dyspnea.
Keywords: COPD, Dyspnea, Anxiety, Depression, HADS.