Cleland Jennifer A, Lee Amanda J, Hall Susan
Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, UK.
Fam Pract. 2007 Jun;24(3):217-23. doi: 10.1093/fampra/cmm009. Epub 2007 May 15.
Under-diagnosis of anxiety and depression in Chronic Obstructive Pulmonary Disease (COPD) patients may have a negative impact on patient quality of life and result in disparity between prevalence and the recognition and treatment of these symptoms.
To reveal associations of depression and anxiety with demographic, health-related quality of life and clinical characteristics of COPD patients seen in UK primary care.
Cross-sectional population-based postal survey of COPD patients comprising the EQ-5D visual analogue scale (EQ-5D(VAS)), the COPD symptom control questionnaire, the Hospital Anxiety and Depression Scale, the Medical Research Council dyspnea index. Demographic and spirometric data were collected from general practice records.
A total of 170 (57%) patients consented to take part. Data are reported on 110 of these patients for whom up-to-date spirometry was available. Approximately one in five participants reported 'caseness' for depression (20.8%) and one in three reported anxiety (32.7%). Age and high levels of symptoms were independent predictors of anxiety and depression, as was the EQ-5D(VAS) of depression.
These data suggest that in UK primary care, depressive and anxious symptoms in COPD are related to age and high levels of symptoms. Depression is also associated with lower patient-reported generic health status. The data suggest that assessment and treatment for depression and anxiety should be considered for all COPD patients, not just those with more severe clinical levels of disease. The potential of the EQ-5D(VAS) as a screening tool for anxiety and depression in primary care COPD patients also merits study.
慢性阻塞性肺疾病（COPD）患者中焦虑和抑郁的诊断不足可能会对患者生活质量产生负面影响，并导致这些症状的患病率与识别和治疗之间存在差异。
揭示在英国初级医疗中就诊的COPD患者的抑郁和焦虑与人口统计学、健康相关生活质量及临床特征之间的关联。
基于人群的COPD患者横断面邮寄调查，包括EQ-5D视觉模拟量表（EQ-5D(VAS)）、COPD症状控制问卷、医院焦虑抑郁量表、医学研究委员会呼吸困难指数。从全科医疗记录中收集人口统计学和肺功能数据。
共有170名（57%）患者同意参与。报告其中110名有最新肺功能检查数据患者的数据。约五分之一的参与者报告有抑郁“病例”（20.8%），三分之一报告有焦虑（32.7%）。年龄和高水平症状是焦虑和抑郁的独立预测因素，抑郁的EQ-5D(VAS)也是如此。
这些数据表明，在英国初级医疗中，COPD患者的抑郁和焦虑症状与年龄和高水平症状有关。抑郁还与患者报告的总体健康状况较低有关。数据表明，应考虑对所有COPD患者进行抑郁和焦虑的评估和治疗，而不仅仅是那些临床疾病程度更严重的患者。EQ-5D(VAS)作为初级医疗中COPD患者焦虑和抑郁筛查工具的潜力也值得研究。
