Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India.
Corresponding Author: Kiran Kumar Gudivada, DM, Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Bibinagar, Hyderabad Metropolitan Region 508126, Telangana, India (
Prim Care Companion CNS Disord. 2023 Oct 5;25(5):23m03490. doi: 10.4088/PCC.23m03490.
To determine the rates of new-onset anxiety and depression in patients with restrictive or obstructive lung disease after COVID-19 infection and to assess the improvement in pulmonary functions and anxiety/depression scores after prescribing incentive spirometer-based breathing exercises. A 2-phase study with a cross-sectional and open-label randomized interventional design evaluated anxiety (Generalized Anxiety Disorder-7 [GAD-7] and Hamilton Anxiety Rating Scale [HARS]), depression (Patient Health Questionnaire-9 [PHQ-9]), and pulmonary function tests (PFTs) of 100 COVID-19 patients within 8 weeks of acute illness. Patients with pulmonary dysfunction were randomized (incentive spirometry vs controls), and anxiety/depression scores and lung function were reevaluated after 4 weeks. The results revealed 35% (35/100) of mild-moderate COVID-19 patients had abnormal PFTs. Anxiety/depression was higher in patients with abnormal PFTs than in those with normal lung function (prevalence ratio: 1.8 [20% vs 11%]). The median HARS, GAD-7, and PHQ-9 scores decreased significantly with 4 weeks of incentive spirometry exercises (2 [0-5.5, .013], 2 [0-3.5, .006], and 2 [0-3.5, .006], respectively) compared to standard of care alone. More patients with incentive spirometry had normalization of pulmonary functions compared to controls (50% [8/16] vs 33% [6/18]). The mean age of patients with anxiety/depression was significantly higher than those without anxiety/depression (42±11 vs 30± 7, .04). While the rates of new-onset anxiety/depression were higher in patients with pulmonary dysfunction, these rates were reduced with incentive spirometer-based exercises. Greater age may be a risk factor for abnormal pulmonary functions and greater anxiety or depression. Clinical Trials Registry-India identifier: CTRI/2022/11/047183. .
确定 COVID-19 感染后限制性或阻塞性肺疾病患者新发焦虑和抑郁的发生率，并评估基于激励式呼吸训练器的呼吸练习对改善肺功能和焦虑/抑郁评分的效果。采用两阶段研究设计，包括横断面和开放标签随机干预设计，评估了 100 名 COVID-19 患者在急性疾病后 8 周内的焦虑（广泛性焦虑障碍 7 项量表[GAD-7]和汉密尔顿焦虑量表[HARS]）、抑郁（患者健康问卷 9 项量表[PHQ-9]）和肺功能测试（PFT）。在肺功能障碍患者中进行随机分组（激励式呼吸训练器组与对照组），并在 4 周后再次评估焦虑/抑郁评分和肺功能。结果：35%（35/100）轻度至中度 COVID-19 患者的 PFT 异常。与肺功能正常的患者相比，PFT 异常的患者焦虑/抑郁程度更高（流行率比：1.8 [20%比 11%]）。与单独接受标准治疗相比，4 周的激励式呼吸训练可显著降低 HARS、GAD-7 和 PHQ-9 评分中位数（2 [0-5.5，.013]、2 [0-3.5，.006]和 2 [0-3.5，.006]）。与对照组相比，激励式呼吸训练组有更多患者的肺功能恢复正常（50% [8/16]比 33% [6/18]）。有焦虑/抑郁的患者的平均年龄明显高于无焦虑/抑郁的患者（42±11 岁比 30±7 岁，.04）。虽然肺功能障碍患者新发焦虑/抑郁的发生率较高，但通过激励式呼吸训练可降低其发生率。年龄较大可能是肺功能异常和焦虑或抑郁程度较高的危险因素。临床试验注册印度标识号：CTRI/2022/11/047183。
