Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
Medicines Evaluation Unit, Manchester University NHS Foundation Trust, Manchester, UK.
Int J Chron Obstruct Pulmon Dis. 2023 Jun 13;18:1187-1195. doi: 10.2147/COPD.S405050. eCollection 2023.
Chronic obstructive pulmonary disease (COPD) is multifaceted, with some patients experiencing anxiety and depression. Depression in COPD has been associated with worse total scores for the COPD assessment test (CAT). Also, CAT score worsening has been observed during the COVID-19 pandemic. The relationship between the Center for Epidemiologic Studies Depression Scale (CES-D) score and CAT sub-component scores has not been evaluated. We investigated the relationship between CES-D score and CAT component scores during the COVD-19 pandemic.
Sixty-five patients were recruited. Pre-pandemic (baseline) was defined as 23rd March 2019-23rd March 2020, CAT scores and information related to exacerbations were collected via telephone at 8-week intervals between 23rd March 2020-23rd March 2021.
There were no differences in CAT scores pre- compared to during the pandemic (ANOVA p = 0.97). Total CAT scores were higher in patients with symptoms of depression compared to those without both pre- (p < 0.001) and during-pandemic (eg, at 12 months 21.2 versus 12.9, mean difference = 8.3 (95% CI = 2.3-14.2), p = 0.02). Individual CAT component scores showed significantly higher chest tightness, breathlessness, activity limitation, confidence, sleep and energy scores in patients with symptoms of depression at most time points (p < 0.05). Significantly fewer exacerbations were observed during- compared to pre-pandemic (p = 0.04). We observed that COPD patients with symptoms of depression had higher CAT scores both pre- and during the COVID-19 pandemic.
Presence of depressive symptoms was selectively associated with individual component scores. Symptoms of depression may potentially influence total CAT scores.
慢性阻塞性肺疾病（COPD）具有多面性，部分患者会出现焦虑和抑郁。COPD 患者的抑郁与 COPD 评估测试（CAT）的总评分恶化有关。此外，在 COVID-19 大流行期间，也观察到 CAT 评分恶化。尚未评估中心流行病学研究抑郁量表（CES-D）评分与 CAT 子成分评分之间的关系。我们研究了 COVID-19 大流行期间 CES-D 评分与 CAT 成分评分之间的关系。
共招募了 65 名患者。大流行前（基线）定义为 2019 年 3 月 23 日至 2020 年 3 月 23 日，通过电话收集 2020 年 3 月 23 日至 2021 年 3 月 23 日 8 周间隔的 CAT 评分和与加重相关的信息。
与大流行前相比，CAT 评分无差异（方差分析 p = 0.97）。与无抑郁症状的患者相比，有抑郁症状的患者的总 CAT 评分更高，无论在大流行前（p < 0.001）还是大流行期间（例如，在 12 个月时为 21.2 与 12.9，平均差异为 8.3（95%CI = 2.3-14.2），p = 0.02）。在大多数时间点，有抑郁症状的患者的 CAT 各个成分评分显示出明显更高的胸闷、呼吸困难、活动受限、信心、睡眠和精力评分（p < 0.05）。与大流行前相比，观察到大流行期间的加重次数明显减少（p = 0.04）。我们发现，COPD 患者有抑郁症状时，大流行前和大流行期间的 CAT 评分均较高。
存在抑郁症状与个别成分评分相关。抑郁症状可能会影响 CAT 总分。
