Wang Jing Gennie, Bose Sonali, Holbrook Janet T, Nan Lin, Eakin Michelle N, Yohannes Abebaw M, Wise Robert A, Hanania Nicola A
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, United States.
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Chronic Obstr Pulm Dis. 2025 Jan 29;12(1):33-42. doi: 10.15326/jcopdf.2024.0534.
Most studies on mental health among individuals with chronic obstructive pulmonary disease (COPD) utilize screening questionnaires, which detect psychiatric , but cannot be used to depression/anxiety disorders. We utilized the Mini-International Neuropsychiatric Interview (MINI) to identify depression/anxiety disorders meeting the diagnostic criteria and described associated disease burden in people with COPD.
This is a cross-sectional, secondary analysis of a multicenter study designed to evaluate anxiety questionnaires in COPD patients. Research coordinators administered both the MINI and screening questionnaires to determine participants who met diagnostic criteria for depression/anxiety disorders and to capture symptom burden, respectively. Bivariate analyses were conducted to assess differences in COPD and patient-reported outcomes between those with and without depression/anxiety disorders.
Of 220 participants, 18 (8%) met the MINI criteria for depression and 17 (8%) for anxiety. Depression was associated with more breathlessness (modified Medical Research Council Dyspnea Scale 4 versus 3, =0.045), higher COPD disease burden (COPD Assessment Test [CAT] 27 versus 17, <0.001), worse sleep quality (Pittsburgh Sleep Quality Index 11 versus 7, =0.001) and health-related quality of life (5-Level EQ-5D 0.31 versus 0.59, <0.001). Anxiety was associated with lower CAT scores and worse health-related quality of life and function. Most with depression/anxiety disorders were not using antidepressants/anxiolytics, or receiving mental health counseling.
Depression and anxiety disorders meeting diagnostic criteria are relatively common comorbidities that substantially impair quality of life and are undertreated, highlighting a need to prioritize mental health as an integral part of comprehensive COPD care.
大多数关于慢性阻塞性肺疾病（COPD）患者心理健康的研究使用筛查问卷，这些问卷能检测出精神疾病，但不能用于诊断抑郁症/焦虑症。我们使用迷你国际神经精神病学访谈（MINI）来识别符合诊断标准的抑郁症/焦虑症，并描述COPD患者的相关疾病负担。
这是一项对多中心研究的横断面二次分析，该研究旨在评估COPD患者的焦虑问卷。研究协调员同时发放MINI问卷和筛查问卷，以分别确定符合抑郁症/焦虑症诊断标准的参与者，并获取症状负担。进行双变量分析以评估有或没有抑郁症/焦虑症的患者在COPD及患者报告结局方面的差异。
在220名参与者中，18人（8%）符合MINI抑郁症标准，17人（8%）符合焦虑症标准。抑郁症与更多的呼吸急促（改良医学研究理事会呼吸困难量表4级对3级，P = 0.045）、更高的COPD疾病负担（COPD评估测试[CAT] 27对17，P < 0.001）、更差的睡眠质量（匹兹堡睡眠质量指数11对7，P = 0.001）以及与健康相关的生活质量（5级EQ - 5D 0.31对0.59，P < 0.001）相关。焦虑症与较低的CAT评分以及较差的与健康相关的生活质量和功能相关。大多数患有抑郁症/焦虑症的患者未使用抗抑郁药/抗焦虑药，也未接受心理健康咨询。
符合诊断标准的抑郁症和焦虑症是相对常见的合并症，会严重损害生活质量且治疗不足，这凸显了将心理健康作为综合COPD护理不可或缺的一部分加以优先考虑的必要性。
