Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA.
Gen Hosp Psychiatry. 2021 Mar-Apr;69:1-6. doi: 10.1016/j.genhosppsych.2020.12.004. Epub 2020 Dec 14.
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Depression and anxiety worsen COPD and lead to greater respiratory symptom severity and health care utilization. Fear of physical sensations of anxiety (AS-P) is known to exacerbate respiratory symptoms. The current study investigated the unique contribution of AS-P in respiratory symptom exacerbations, emergency department visits, hospitalizations, and COPD-related functional health status, controlling for medical characteristics, depression, and anxiety.
The sample included 535 adults with COPD (M = 56.57; 58.1% male). Participants were recruited from a web-based panel of adults with chronic respiratory disease and completed an online battery of self-report measures.
Consistent with hypotheses, AS-P significantly increased the likelihood of acute symptom exacerbations by 12% and respiratory-related emergency department visits and hospitalizations by 7% during the prior 12 month period. Additionally, AS-P demonstrated a unique, large effect (f = 0.37) on COPD-related functional health status.
Fear of physical sensations contributed to worse respiratory outcomes and health care utilization among adults with COPD. Screening for AS-P may effectively identify at-risk COPD patients, while reducing AS-P through targeted interventions may result in decreased symptom severity, functional limitations, and burden on the health care system.
慢性阻塞性肺疾病（COPD）是全球发病率和死亡率的主要原因。抑郁和焦虑会使 COPD 恶化，并导致更严重的呼吸症状和更多的医疗保健利用。已知对焦虑的身体感觉的恐惧（AS-P）会使呼吸症状恶化。本研究调查了 AS-P 在呼吸症状恶化、急诊就诊、住院和 COPD 相关功能健康状况方面的独特贡献，同时控制了医疗特征、抑郁和焦虑。
该样本包括 535 名患有 COPD 的成年人（M=56.57；58.1%为男性）。参与者从一个基于网络的慢性呼吸道疾病成年人小组中招募，并完成了一系列在线自我报告措施。
与假设一致，AS-P 在过去 12 个月期间使急性症状恶化的可能性增加了 12%，使与呼吸相关的急诊就诊和住院的可能性增加了 7%。此外，AS-P 对 COPD 相关功能健康状况有独特的、较大的影响（f=0.37）。
对身体感觉的恐惧会导致 COPD 成年人的呼吸结果和医疗保健利用情况恶化。对 AS-P 进行筛查可能会有效地识别高危 COPD 患者，而通过有针对性的干预措施降低 AS-P 可能会降低症状严重程度、功能限制和对医疗保健系统的负担。
