Top

Published in:

Open Access 01-12-2010 | Research

Factors affecting the relationship between psychological status and quality of life in COPD patients

Authors: Eva Balcells, Joaquim Gea, Jaume Ferrer, Ignasi Serra, Mauricio Orozco-Levi, Jordi de Batlle, Esther Rodriguez, Marta Benet, David Donaire-González, Josep M Antó, Judith Garcia-Aymerich, the PAC-COPD Study Group

Published in: Health and Quality of Life Outcomes | Issue 1/2010

Abstract

Background

This study aims to (i) evaluate the association between anxiety and depressive symptoms and health-related quality of life (HRQoL); and (ii) identify the effect modifiers of this relationship in patients with chronic obstructive pulmonary disease (COPD).

Methods

A total of 337 clinically stable COPD patients answered the St. George's Respiratory Questionnaire (SGRQ) (assessing HRQoL) and the Hospital Anxiety and Depression Scale (HADS). Socio-demographic information, lung function, and other clinical data were collected.

Results

Most patients (93%) were male; they had a mean (SD) age of 68 (9) years and mild to very severe COPD (post-bronchodilator FEV₁ 52 (16)% predicted). Multivariate analyses showed that anxiety, depression, or both conditions were associated with poor HRQoL (for all SGRQ domains). The association between anxiety and total HRQoL score was 6.7 points higher (indicating a worse HRQoL) in current workers than in retired individuals. Estimates for patients with "both anxiety and depression" were 5.8 points lower in stage I-II than in stage III-IV COPD, and 10.2 points higher in patients with other comorbidities than in those with only COPD.

Conclusions

This study shows a significant association between anxiety, depression, or both conditions and impaired HRQoL. Clinically relevant factors affecting the magnitude of this association include work status, COPD severity, and the presence of comorbidities.

Available only for authorised users

Curtis JR, Patrick DL: The assessment of health status among patients with COPD. Eur Respir J 2003,21(Suppl 41):36–45. 10.1183/09031936.03.00078102CrossRef

Osman LM, Godden DJ, Friend JA, Legge JS, Douglas JG: Quality of life and hospital re-admission in patients with chronic obstructive pulmonary disease. Thorax 1997, 52: 67–71. 10.1136/thx.52.1.67PubMedCentralPubMedCrossRef

Domingo-Salvany A, Lamarca R, Ferrer M, Garcia-Aymerich J, Alonso J, Félez M, Khalaf A, Marrades RM, Monsó E, Serra-Batlles J, Antó JM: Health-related quality of life and mortality in male patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2002, 166: 680–685. 10.1164/rccm.2112043PubMedCrossRef

Ferrer M, Alonso J, Morera J, Marrades RM, Khalaf A, Aguar C, Plaza V, Prieto L, Antó JM: Chronic obstructive pulmonary disease stage and health-related quality of life. Ann Intern Med 1997, 127: 1072–1079.PubMedCrossRef

Wijnhoven HA, Kriegsman DM, Hesselink AE, de Haan M, Schellevis FG: The influence of co-morbidity on health-related quality of life in asthma and COPD patients. Respir Med 2003, 97: 468–475. 10.1053/rmed.2002.1463PubMedCrossRef

Ketelaars CA, Schlösser MA, Mostert R, Huyer Abu-Saad H, Halfens RJ, Wouters EF: Determinants of health-related quality of life in patients with chronic obstructive pulmonary disease. Thorax 1996, 51: 39–43. 10.1136/thx.51.1.39PubMedCentralPubMedCrossRef

Wijnhoven HA, Kriegsman DM, Hesselink AE, Penninx BW, de Haan M: Determinants of different dimensions of disease severity in asthma and COPD. Chest 2001, 119: 1034–1042. 10.1378/chest.119.4.1034PubMedCrossRef

Hill K, Geist R, Goldstein RS, Lacasse Y: Anxiety and depression in end-stage COPD. Eur Respir J 2008, 31: 667–677. 10.1183/09031936.00125707PubMedCrossRef

Maurer J, Rebbapragada V, Borson S, Goldstein R, Kunik ME, Yohannes AM, Hanania NA, for the ACCP Workshop Panel on Anxiety and Depression in COPD: Anxiety and depression in COPD: current understanding, unanswered questions, and research needs. Chest 2008, 134: 43–56. 10.1378/chest.08-0342CrossRef

10.

Gudmundsson G, Gislason T, Janson C, Lindberg E, Suppli Ulrik C, Brøndum E, Nieminen MM, Aine T, Hallin R, Bakke P: Depression, anxiety and health status after hospitalisation for COPD: a multicentre study in the Nordic countries. Respir Med 2006, 100: 87–93. 10.1016/j.rmed.2005.04.003PubMedCrossRef

11.

Ng TP, Niti M, Tan WC, Cao Z, Ong KC, Eng P: Depressive symptoms and chronic obstructive pulmonary disease. Arch Intern Med 2007, 167: 60–67. 10.1001/archinte.167.1.60PubMedCrossRef

12.

Omachi TA, Katz PP, Yelin EH, Gregorich SE, Iribarren C, Blanc PD, Eisner MD: Depression and health-related quality of life in chronic obstructive pulmonary disease. Am J Med 2009,122(8):778. 9–15. 10.1016/j.amjmed.2009.01.036PubMedCentralPubMedCrossRef

13.

Hajiro T, Nishimura K, Tsukino M, Ikeda A, Oga T: Stages of disease severity and factors that affect health status of patients with chronic obstructive pulmonary disease. Respir Med 2000, 94: 841–6. 10.1053/rmed.2000.0804PubMedCrossRef

14.

Garcia-Aymerich J, Gómez FP, Antó JM, on behalf of the PAC-COPD Research Study Group: Phenotype characterisation and course of chronic obstructive pulmonary disease (COPD) in the PAC-COPD Study: design and methods. Arch Bronconeumol 2009, 45: 4–11. 10.1016/j.arbres.2008.03.001PubMed

15.

Celli BR, MacNee W, ATS/ERS Task Force: Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004, 23: 932–946. 10.1183/09031936.04.00014304PubMedCrossRef

16.

Balcells E, Antó JM, Gea J, Gómez FP, Rodríguez E, Marin A, Ferrer A, de Batlle J, Farrero E, Benet M, Orozco-Levi M, Ferrer J, Agustí AG, Gáldiz JB, Belda J, Garcia-Aymerich J, PAC-COPD Study Group: Characteristics of patients admitted for the first time for a COPD exacerbation. Respir Med 2009, 103: 1293–1302. 10.1016/j.rmed.2009.04.001PubMedCrossRef

17.

Ferrer M, Alonso J, Prieto L, Plaza V, Monsó E, Marrades R, Aguar MC, Khalaf A, Antó JM: Validity and reliability of the St George's Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example. Eur Respir J 1996, 9: 1160–1166. 10.1183/09031936.96.09061160PubMedCrossRef

18.

Jones PW, Quirk FH, Baveystock CM: The St. George's Respiratory Questionnaire. Respir Med 1991, 85: 25–31. 10.1016/S0954-6111(06)80166-6PubMedCrossRef

19.

Jones PW: Health status measurement in chronic obstructive pulmonary disease. Thorax 2001, 56: 880–887. 10.1136/thorax.56.11.880PubMedCentralPubMedCrossRef

20.

Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983, 67: 361–370. 10.1111/j.1600-0447.1983.tb09716.xPubMedCrossRef

21.

Quintana JM, Padierna A, Esteban C, Arostegui I, Bilbao A, Ruiz I: Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 2003, 107: 216–221. 10.1034/j.1600-0447.2003.00062.xPubMedCrossRef

22.

Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002, 52: 69–77. 10.1016/S0022-3999(01)00296-3PubMedCrossRef

23.

Mahoney F, Barthel D: Functional evaluation: the Barthel Index. Md State Med J 1965, 14: 61–65.PubMed

24.

Armitage P, Berry G: Multiple measurements. In Statistical Methods in Medical Research. Oxford: Blackwell Scientific Publications; 1987:308–312.

25.

Putman-Casdorph H, McCrone S: COPD, Depression, and Anxiety-State of the Science. Heart and Lung 2009, 38: 34–47. 10.1016/j.hrtlng.2008.02.005PubMedCrossRef

26.

Rennard S, Decramer M, Calverley PMA, Pride MB, Soriano JB, Vermeire PA, Vestbo J: Impact of COPD in North America and Europe in 2000: subjects'perspective of Confronting COPD International Survey. Eur Respir J 2002, 20: 799–805. 10.1183/09031936.02.03242002PubMedCrossRef

27.

Eisner MD, Yelin EH, Trupin L, Blanc PD: The influence of chronic respiratory conditions on health status and work disability. Am J Public Health 2002, 92: 1506–1513. 10.2105/AJPH.92.9.1506PubMedCentralPubMedCrossRef

28.

Di Marco F, Verga M, Reggente M, Casanova FM, Santus P, Blasi F, Allegra L, Centanni S: Anxiety and depression in COPD patients: the roles of gender and disease severity. Respir Med 2006, 100: 1767–1774. 10.1016/j.rmed.2006.01.026PubMedCrossRef

29.

Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2009. [http://www.goldcopd.org] --- Either ISSN or Journal title must be supplied.

30.

World Health Organization: Innovative Care for Chronic Conditions: Building Blocks for Action: Global Report 2002. WHO Library Cataloging-in-Publication Data; 2002. --- Either first page or author must be supplied.

31.

McCathie HCF, Spence SH, Tate RL: Adjustment to chronic obstructive pulmonary disease: the importance of psychological factors. Eur Respir J 2002, 19: 47–53. 10.1183/09031936.02.00240702PubMedCrossRef

32.

Cleland JA, Lee AJ, Hall S: Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. Fam Pract 2007, 24: 217–223. 10.1093/fampra/cmm009PubMedCrossRef

Title: Factors affecting the relationship between psychological status and quality of life in COPD patients
Authors: Eva Balcells
Joaquim Gea
Jaume Ferrer
Ignasi Serra
Mauricio Orozco-Levi
Jordi de Batlle
Esther Rodriguez
Marta Benet
David Donaire-González
Josep M Antó
Judith Garcia-Aymerich
the PAC-COPD Study Group
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2010
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-8-108

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Factors affecting the relationship between psychological status and quality of life in COPD patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

Comparison of numerical and verbal rating scales to measure pain exacerbations in patients with chronic cancer pain

Health-related quality of life in patients with severe COPD hospitalized for exacerbations - comparing EQ-5D, SF-12 and SGRQ

Self-reported physical and mental health status and quality of life in adolescents: a latent variable mediation model

Quality of life in colon cancer patients with skin side effects: preliminary results from a monocentric cross sectional study

Psychometric properties of an instrument for assessing the experience of patients treated with inhaled insulin: the Inhaled Insulin Treatment Questionnaire (IITQ)

Do urinary tract infections affect morale among very old women?