Parreira Verônica Franco, Kirkwood Renata N, Towns Megan, Aganon Isabel, Barrett Lauren, Darling Catherine, Lee Michelle, Hill Kylie, Goldstein Roger S, Brooks Dina
Can Respir J. 2015 Jan-Feb;22(1):37-41. doi: 10.1155/2015/478528. Epub 2014 Nov 6.
In addition to symptoms, such as dyspnea and fatigue, patients with chronic obstructive pulmonary disease (COPD) also experience mood disturbances.
To explore the relationships between health-related quality of life measures collected from patients with stable COPD and a commonly used measure of depression and anxiety.
The present analysis was a retrospective study of patients with COPD enrolled in a pulmonary rehabilitation program. Hospital Anxiety and Depression Scale (HADS), Chronic Respiratory Disease Questionnaire (CRQ), Medical Research Council dyspnea scale and 6 min walk test data were collected. Statistical analyses were performed using Spearman's correlations, and categorical regression and categorical principal component analysis were interpreted using the biplot methodology.
HADS anxiety scores retrieved from 80 patients were grouped as 'no anxiety' (n=43 [54%]), 'probable anxiety' (n=21 [26%]) and 'presence of anxiety' (n=16 [20%]). HADS depression scores were similarly grouped. There was a moderate relationship between the anxiety subscale of the HADS and both the emotional function (r=-0.519; P<0.01) and mastery (r=-0.553; P<0.01) domains of the CRQ. Categorical regression showed that the CRQ-mastery domain explained 40% of the total variation in anxiety. A principal component analysis biplot showed that the highest distance between the groups was along the mastery domain, which separated patients without feelings of anxiety from those with anxiety. However, none of the CRQ domains were able to discriminate the three depression groups.
The CRQ-mastery domain may identify symptoms of anxiety in patients with COPD; however, the relationship is not strong enough to use the CRQ-mastery domain as a surrogate measure. None of the CRQ domains were able to discriminate the three depression groups (no depression, probable and presence); therefore, specific, validated tools to identify symptoms of depression should be used.
除了诸如呼吸困难和疲劳等症状外，慢性阻塞性肺疾病（COPD）患者还会出现情绪障碍。
探讨从稳定期COPD患者收集的健康相关生活质量指标与一种常用的抑郁和焦虑测量指标之间的关系。
本分析是一项对参加肺康复计划的COPD患者的回顾性研究。收集医院焦虑抑郁量表（HADS）、慢性呼吸系统疾病问卷（CRQ）、医学研究委员会呼吸困难量表和6分钟步行试验数据。采用Spearman相关性进行统计分析，并使用双标图方法解释分类回归和分类主成分分析。
从80名患者中获取的HADS焦虑评分分为“无焦虑”（n = 43 [54%]）、“可能有焦虑”（n = 21 [26%]）和“存在焦虑”（n = 16 [20%]）。HADS抑郁评分也进行了类似分组。HADS焦虑分量表与CRQ的情绪功能（r = -0.519；P < 0.01）和掌控感（r = -0.553；P < 0.01）领域之间存在中度关系。分类回归显示，CRQ-掌控感领域解释了焦虑总变异的40%。主成分分析双标图显示，各组之间的最大距离沿着掌控感领域，该领域将无焦虑感的患者与有焦虑感的患者区分开来。然而，CRQ的任何领域都无法区分三个抑郁组。
CRQ-掌控感领域可能识别COPD患者的焦虑症状；然而，这种关系不够强，不足以将CRQ-掌控感领域用作替代指标。CRQ的任何领域都无法区分三个抑郁组（无抑郁、可能有抑郁和存在抑郁）；因此，应使用特定的、经过验证的工具来识别抑郁症状。
