韩国一项前瞻性队列研究：非结核分枝杆菌肺病患者的焦虑和抑郁

Anxiety and Depression in Patients With Nontuberculous Mycobacterial Pulmonary Disease: A Prospective Cohort Study in South Korea.

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Clinical Trials Center, Seoul National University Hospital, Seoul, South Korea.

出版信息

Chest. 2022 Apr;161(4):918-926. doi: 10.1016/j.chest.2021.10.024. Epub 2021 Oct 28.

DOI:10.1016/j.chest.2021.10.024

PMID:34756943

Abstract

BACKGROUND

The mental health of patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) has been underestimated.

RESEARCH QUESTION

What is the prevalence of, associated factors for, and clinical impact of anxiety and depression in patients with NTM-PD?

STUDY DESIGN AND METHODS

Among patients diagnosed with NTM-PD between July 1, 2011, and December 31, 2019, who were part of Seoul National University Hospital's prospective cohort, this study included those who completed the Hospital Anxiety and Depression Scale (HADS) at least twice. Multivariable logistic regression analysis was used to identify the factors associated with anxiety and depression. Multilevel mixed effects regression was used to analyze longitudinal trends of the HADS scores.

RESULTS

A total of 368 patients were included in this study, including 84 (22.8%) with anxiety (Hospital Anxiety and Depression Scale-Anxiety score ≥ 8) and 83 (22.5%) with depression (Hospital Anxiety and Depression Scale-Depression score ≥ 8). The presence of cough (adjusted OR [aOR], 2.01; 95% CI, 1.19-3.39) and febrile sensation (aOR, 4.45; 95% CI, 2.13-9.30) were associated with anxiety, whereas dyspnea (aOR, 4.13; 95% CI, 1.38-12.37) and febrile sensation (aOR, 2.91; 95% CI, 1.38-6.13) were associated with depression. Although the HADS scores of patients with anxiety or depression at the time of enrollment and throughout the follow-up period were higher than those without, these scores declined significantly within 1 year following enrollment. Patients with anxiety (P = .006) or depression (P = .004) received antibiotic treatment more frequently than those without. Treatment outcomes did not differ depending on the initial anxiety or depression status.

INTERPRETATION

Anxiety and depression were common in patients with NTM-PD and were associated with patient-reported symptoms. Although these persisted over time, the treatment outcomes did not differ.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov; No.: NCT01616745; URL: www.

CLINICALTRIALS

gov.

摘要

背景

非结核分枝杆菌肺病（NTM-PD）患者的心理健康一直被低估。

研究问题

NTM-PD 患者焦虑和抑郁的患病率、相关因素和临床影响是什么？

研究设计和方法

在 2011 年 7 月 1 日至 2019 年 12 月 31 日期间被诊断为 NTM-PD 并参加首尔国立大学医院前瞻性队列研究的患者中，本研究纳入了至少两次完成医院焦虑和抑郁量表（HADS）的患者。采用多变量逻辑回归分析确定与焦虑和抑郁相关的因素。采用多级混合效应回归分析 HADS 评分的纵向趋势。

结果

本研究共纳入 368 例患者，其中 84 例（22.8%）有焦虑（HADS 焦虑评分≥8），83 例（22.5%）有抑郁（HADS 抑郁评分≥8）。咳嗽（调整后的比值比[OR]，2.01；95%可信区间[CI]，1.19-3.39）和发热感（OR，4.45；95%CI，2.13-9.30）与焦虑相关，而呼吸困难（OR，4.13；95%CI，1.38-12.37）和发热感（OR，2.91；95%CI，1.38-6.13）与抑郁相关。尽管在入组时和整个随访期间有焦虑或抑郁的患者的 HADS 评分高于无焦虑或抑郁的患者，但在入组后 1 年内这些评分显著下降。有焦虑（P=.006）或抑郁（P=.004）的患者比无焦虑或抑郁的患者更频繁地接受抗生素治疗。初始焦虑或抑郁状态并不影响治疗结局。