Chest
Volume 87, Issue 1, January 1985, Pages 35-38
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Prevalence of Depression and Anxiety in Patients with COPD: Relationship to Functional Capacity

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The objective of this study was twofold: (1) to document the prevalence of depression and anxiety in patients with moderate or severe chronic obstructive pulmonary disease; and (2) to determine whether the presence of depression or anxiety adversely affected the functional capabilities of the patient as reflected by the distance he could walk in 12 minutes. Forty-five patients with an FEV1 < 1,250 ml underwent pulmonary function testing including spirometry, single breath diffusing capacity, and arterial blood gas determinations. The degree of depression was assessed by the Beck depression inventory, while the degree of anxiety was assessed by the State-Trait anxiety inventory. Forty-two percent of the patients had significant depression, while only 2 percent of the patients had significant anxiety. There was a highly significant correlation between the depression scores and the anxiety scores (r = 0.81, p < 0.001). There was no significant correlation between the level of depression or anxiety and the distance that the patient could walk in 12 minutes. From this study, we conclude that the prevalence of depression in patients with moderate or severe COPD approaches 50 percent while the incidence of anxiety is much lower (2 percent).

Section snippets

Patient Population

The participants in the study were recruited from the outpatient pulmonary clinic at the Veterans Administration Medical Center, Long Beach, California. To be considered as a candidate for participation in this study, the forced expiratory volume in one second (FEV1) of the patient was required to be below 1,250 ml and the ratio of the FEV1 to the forced vital capacity (FVC) was required to be less than 50 percent. In addition, the patient had to be between 40 and 70 years old and with his

RESULTS

The demographic characteristics of the 45 patients who completed the study are summarized in Table 1. All patients were men. Thirty five of the 45 patients had severe COPD as defined as an FEV1 less than 1,000 ml and/or an FEV1/FVC less than .40. The participants in the study had a substantial amount of emphysema since their mean Dco expressed as percent predicted of the normal value was less than 50 percent. The mean PaO2 was below normal, but only four of the patients (9 percent) had a PaO2

DISCUSSION

The present study documents that there is a high prevalence of depression in patients with moderate or severe COPD. The prevalence of depression in the present study (42 percent) is similar to that reported by McSweeny et al8 in a group of patients with severe COPD (mean FEV1 = 750 ml) and severe hypoxemia (PaO2 < 60 mm Hg). Other studies have also reported that patients with COPD tend to be depressed.3,4,5,7

It appears that the prevalence of depression is higher in patients with COPD than it is

ACKNOWLEDGMENTS

We thank Ms. Kaye Lines and Ms. Karen Lopresti for performing the pulmonary function testing. We thank Ms. Linda Light for editorial assistance with the manuscript.

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