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精神共病与生活质量和慢性阻塞性肺疾病严重程度的关联

Association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease.

作者信息

Mehta J R, Ratnani I J, Dave J D, Panchal B N, Patel A K, Vala A U

机构信息

Department of Pulmonary Medicine, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.

Department of Psychiatry, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.

出版信息

East Asian Arch Psychiatry. 2014 Dec;24(4):148-55.

Abstract

OBJECTIVE

This was a single-centre, cross-sectional, observational study performed at a tertiary care hospital in India to study the association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease (COPD).

METHODS

A total of 59 clinically stable patients with COPD were assessed for disease severity, as per the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (2013). Psychiatric co-morbidities like anxiety disorders and depression were diagnosed by clinician-administered interview (as per the DSM-V criteria). Insomnia, anxiety disorders and depression, as well as quality of life were also assessed by self-rating scales including Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and St. George's Respiratory Questionnaire, respectively.

RESULTS

Depression was the commonest psychiatric co-morbidity affecting 32.2% of individuals. Patients with depression and anxiety disorders had higher score in COPD assessment test (p = 0.02 and p = 0.004, respectively), ISI (p < 0.001 and p = 0.01, respectively), and poorer quality of life (p < 0.001 and p = 0.02, respectively) compared with those without these conditions. Patients with severe symptoms of COPD were more likely to suffer from anxiety (p = 0.001), depression (p = 0.01), insomnia (p = 0.01), and have poor quality of life (p < 0.001). Patients in the GOLD-D (i.e. those at high risk and with more symptoms) group had poorer quality of life (p = 0.004) when compared with GOLD-A (low risk and less symptoms) and GOLD-C (high risk and less symptoms) groups.

CONCLUSIONS

Patients with psychiatric co-morbidities have severe symptoms of COPD and poor quality of life.

摘要

目的

这是一项在印度一家三级护理医院进行的单中心、横断面观察性研究,旨在探讨慢性阻塞性肺疾病(COPD)严重程度与精神共病及生活质量之间的关联。

方法

根据最新的全球慢性阻塞性肺疾病倡议(GOLD)指南(2013年),对59例临床稳定的COPD患者进行疾病严重程度评估。通过临床医生访谈(根据DSM-V标准)诊断焦虑症和抑郁症等精神共病。失眠、焦虑症和抑郁症以及生活质量也分别通过自评量表进行评估,包括失眠严重程度指数(ISI)、医院焦虑和抑郁量表以及圣乔治呼吸问卷。

结果

抑郁症是最常见的精神共病,影响了32.2%的个体。与没有这些疾病的患者相比,患有抑郁症和焦虑症的患者在COPD评估测试中的得分更高(分别为p = 0.02和p = 0.004),ISI得分更高(分别为p < 0.001和p = 0.01),生活质量更差(分别为p < 0.001和p = 0.02)。COPD症状严重的患者更易患焦虑症(p = 0.001)、抑郁症(p = 0.01)、失眠(p = 0.01),且生活质量较差(p < 0.001)。与GOLD-A(低风险且症状较少)和GOLD-C(高风险且症状较少)组相比,GOLD-D组(即高风险且症状较多)的患者生活质量更差(p = 0.004)。

结论

患有精神共病的患者COPD症状严重,生活质量差。

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