Background and aim: Patients with COPD and concurrent depression and/or anxiety are known to have an increased risk of exacerbations, morbidity, mortality, and deteriorated quality of life. Early detection of depression/anxiety may enable early interventions. The aims of this study were to describe the occurrence of depression and anxiety in primary care patients with COPD in Sweden, and to investigate age and gender differences together with other clinical factors associated with this comorbidity.
Methods: A cross-sectional study was performed on a cohort of patients with doctor's diagnoses of COPD. Patients were randomly selected based on the patients' contact with 98 primary healthcare centers and 13 hospitals in Sweden in 2014. Information about self-reported depression/anxiety, patient characteristics, symptoms, and comorbidity, were collected using patient self-completion questionnaires. Lung function data were extracted from medical records.
Results: Of the 2245 patients recruited, 23% (n = 524) reported depression/anxiety, 29% in women and 16% in men (p <0.001). Factors associated with depression/anxiety were being a woman (OR = 2.06 [95% CI 1.56-2.72]), current smoking (1.83 [1.37-2.43]), comorbid asthma (1.77 [1.32-2.37]), dyspnea (the modified Medical Research Council dyspnea scale ≥2 points) (1.58 [1.17-2.13]) and age <65 years (1.57 [1.17-2.10]). The youngest age groups had the highest proportions of patients with depression/anxiety.
Conclusions: Healthcare professionals need to be particularly aware of depression/anxiety in patients with COPD who are younger, women, current smokers, have comorbid asthma, or dyspnea.
Keywords: COPD; anxiety; depression; early COPD; observational studies; primary health care.
Patients with chronic obstructive pulmonary disease (COPD) and comorbid depression and/or anxiety have an increased risk of exacerbations, comorbidity, and mortality. Early detection may enable early interventions.In our study population, nearly one of three women and one of six men with COPD reported having or had depression/anxiety.Comorbid depression/anxiety was most common in the youngest age groups.Depression/anxiety was associated with younger age, being a woman, current smoking, having comorbid asthma, and high levels of dyspnea.An important implication of the study is that primary care professionals should consider the possible occurrence of depression/anxiety in patients with COPD during consultations.