Anxiety and depression are prevalent comorbidities in chronic obstructive pulmonary disease (COPD) and related to worse course of disease. The present study examined the impact of anxiety and depression on functional performance, dyspnea and quality of life in patients with COPD at start and end of an outpatient pulmonary rehabilitation program (PR).
Before and after PR, 238 patients with COPD (mean FEV1% pred = 54; mean age = 62 years) underwent a 6-minute walking test (6MWT). In addition, anxiety, depression, quality of life and dyspnea at rest, after 6MWT and during activities was
Except for dyspnea at rest, improvements were observed in all outcome measures after PR. Multiple regression analyses showed that before and after PR, anxiety and depression were significantly associated with greater dyspnea after 6MWT and during activities and with reduced quality of life, even after controlling for effects of age, sex, lung function and smoking status. Moreover, before and after PR anxiety was related to greater dyspnea at rest, whereas depression was significantly associated with reduced functional performance in the 6MWT.
This study demonstrates that anxiety and depression are significantly associated with increased dyspnea and reduced functional performance and quality of life in patients with COPD. These negative associations remain stable over the course of PR, even when improvements in these outcomes are achieved during PR. The results underline the clinical importance of detecting and treating anxiety and depression in patients with
Andreas von Leupoldt, PhD. (1)(2)
Karin Taube, MD (3)
Kirsten Lehmann (3)
Anja Fritzsche, PhD (1)
Helgo Magnussen, MD (4)
(1) Department of Psychology, University of
Hamburg, Hamburg, Germany
(2) Department of Systems Neuroscience, University Medical Center
(3) Atem-Reha GmbH, Hamburg, Germany
(4) Pulmonary Research Institute at Hospital Grosshansdorf, Grosshansdorf, Germany
CHEST - American College of Chest Physicians