Depression and anxiety may worsen symptoms of chronic obstructive pulmonary disease (COPD) and result in exacerbations and hospitalizations. That is according to a study published in the American Journal of Respiratory and Critical Care Medicine, “Independent Effect of Depression and Anxiety on Chronic Obstructive Pulmonary Disease Exacerbations and Hospitalizations.”
The study, which examined nearly 500 patients with stable COPD in China, measured depression and anxiety using the Hospital Anxiety and Depression Scale (HADS) then monitored the occurrence and characteristics of event-based and symptom-based COPD exacerbations and hospitalization over a 12-month period.
During this period, 876 symptom-based and 450 event-based exacerbations were recorded, among which 183 led to hospitalization. Multivariate Poisson and linear regression analyses were then used to estimate adjusted incidence rate ratios (IRRs) and adjusted effects on duration of events.
What researchers found was that the depression was associated with an increased risk of symptom-based exacerbations, event-based exacerbations, and hospitalization compared with those individuals who were likely not depressed. In addition, event-based exacerbations for those with even probable anxiety were 1.92 times longer than those without anxiety.
While the study does not definitely link depression to worsening of COPD, researchers say that is it possible based on three distinct theories:
· Depression may be linked to immune system changes that leave patients more vulnerable to environmental triggers.
· Depressed patients may be more sensitive to their COPD symptoms and more likely to report those symptoms.
· Depressed patients may not follow their treatment plans as well as other patients, making them more vulnerable to flare-ups.
The good news is that depression screening and treatment is available for those who need it. For more information on how depression and anxiety can affect your disease state, or to connect with a mental health counselor, contact your doctor or healthcare provider.