Anxiety and depression among patients with Bronchial asthma, chronic obstructive pulmonary disease and diffuse parenchymatous lung diseases

摘要

Background: Psychosocial stressors, such as death of a spouse or divorce are closely related to relapses and aggravations of respiratory disease pointing to a link between psychological factors and chronic pulmonary disease. Patients with chronic obstructive pulmonary disease (COPD) cannot cope adequately with everyday needs. This inadequacy may lead to heightened anxiety and depression, which in turn may worsen the everyday inadequacy. It has been reported that this is probably a factor that leads bronchial asthma (BA) and COPD patients to frequent hospital admissions, lower treatment adherence and even intensive care unit hospitalizations . Study objectives: to assess anxiety and depressive symptoms among a sample of Egyptian patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and diffuse parenchymatous lung diseases (DPLD). Subjects & methods : A cross-sectional study conducted over a one year period on a sample of 258 Egyptian patients with chronic breathing disorders who attending the outpatient chest clinic at Al-Zahraa University Hospital. All patients diagnosed as having COPD, BA or DPLD were enrolled into the study. Anxiety and depression were assessed by using the Hospital anxiety and depression scale (HADS) and the Beck Depression Inventory (BDI). Results: Psychiatric disorders were most prevalent among DPLD cases (80.0%), followed by COPD patients (74.0%), while BA group showed the least reported cases (38.8%) with psychiatric disorders, with a statistically significant difference among the studied groups (P-value < 0.05).Depression was prevalent among 60.1% (155/258) of the studied cases, of them 23.2% had severe depression, followed by 38.7 % had moderate depression and 38.1% had mild depression. DPLD cases had the highest proportion of severe depression (31.8), COPD cases had the highest proportion of moderate depression (52.4) and BA group had the highest proportion of mild depression (68.4%), with a statistically significant difference among the studied groups (P-value < 0.05). Conclusion: results of this study revealed that mixed anxiety depression disorders, depression and anxiety were common co-morbidities among the studied sample of the Egyptian patients with DPLD, COPD and those with BA. Recommendations: physicians should take into consideration the assessment of psychiatric co-morbidities among cases with DPLD, COPD and BA