IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; Wolfson Palliative Care Research Centre, University of Hull, Hull, England; Australian National Palliative Clinical Studies Collaborative, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; Australian National Palliative Clinical Studies Collaborative, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
J Pain Symptom Manage. 2020 Feb;59(2):197-205.e2. doi: 10.1016/j.jpainsymman.2019.09.021. Epub 2019 Oct 22.
Breathlessness is associated with depression, but its relationship to anxiety or impaired function is less clear.
This study evaluated associations between chronic breathlessness and anxiety, depression, and functional status in the general population.
This cross-sectional study of consenting adults (18 years and older) used an online survey. Quota sampling (n = 3000) was used reflecting the 2016 national census for sex, age, and place of residence. Other data included Four-Item Patient Health Questionnaire for depression and anxiety, the modified Medical Research Council (mMRC) Breathlessness Scale, and the Australia-modified Karnofsky Performance Scale. Multinomial logistic regression assessed predictors.
About 2977 respondents had all relevant scores (female 51.2%; median age 45.0 [range 18-92]). Prevalence of breathlessness (mMRC ≥2) was 2.4%, anxiety 6.0%, depression 2.7%, coexisting anxiety/depression 6.1%, and poorer functional status (Australia-modified Karnofsky Performance Scale ≤60) 1.6%. In multinomial regression, depression, anxiety, and coexisting anxiety/depression were predicted by younger age, longer duration of breathlessness, and poorer functional status. The highest proportions of people with breathlessness were found in the coexisting anxiety/depression group (10.6%) and depression only group (8.8%). Poorest function was in the coexisting anxiety/depression group with 11.6%. The relationship between poorer functional status and coexisting anxiety/depression was significant (odds ratio 0.90; 95% CI 0.89, 0.92). Adjusted odds ratio for breathlessness and depression only was 3.0 (95% CI 1.2, 7.8).
Clinically important breathlessness (mMRC ≥2) was associated with depression, anxiety, and coexisting anxiety/depression. Poorer function that is associated with psychological morbidity in the general population requires further research.
呼吸困难与抑郁有关，但与焦虑或功能受损的关系尚不清楚。
本研究评估了普通人群中慢性呼吸困难与焦虑、抑郁和功能状态之间的关系。
这项横断面研究招募了同意参与的成年人（18 岁及以上），采用在线调查的方式。配额抽样（n=3000）反映了 2016 年全国人口普查的性别、年龄和居住地。其他数据包括四项目患者健康问卷（用于评估抑郁和焦虑）、改良医学研究委员会呼吸困难量表和澳大利亚改良卡诺夫斯基绩效量表。多分类逻辑回归评估了预测因素。
约 2977 名受访者具有所有相关评分（女性占 51.2%；中位年龄 45.0 [范围 18-92]）。呼吸困难（mMRC≥2）的患病率为 2.4%，焦虑为 6.0%，抑郁为 2.7%，同时存在焦虑/抑郁为 6.1%，功能状态较差（澳大利亚改良卡诺夫斯基绩效量表≤60）为 1.6%。在多分类逻辑回归中，年龄较小、呼吸困难持续时间较长和功能状态较差预测了抑郁、焦虑和同时存在焦虑/抑郁。在同时存在焦虑/抑郁和仅抑郁组中，呼吸困难的比例最高（分别为 10.6%和 8.8%）。在同时存在焦虑/抑郁组中功能状态最差，为 11.6%。功能状态较差与同时存在焦虑/抑郁之间的关系具有统计学意义（比值比 0.90；95%置信区间 0.89，0.92）。呼吸困难和仅抑郁的调整比值比为 3.0（95%置信区间 1.2，7.8）。
临床上重要的呼吸困难（mMRC≥2）与抑郁、焦虑和同时存在焦虑/抑郁有关。与普通人群中心理疾病相关的功能更差需要进一步研究。
