Open AccessAnxiety and depression in adult outpatients with bronchiectasis: Associations with disease severity and health‐related quality of life
Author(s) -
Gao YongHua,
Guan WeiJie,
Zhu YaNan,
Chen RongChang,
Zhang GuoJun
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12695
Subject(s) - medicine , anxiety , depression (economics) , bronchiectasis , pittsburgh sleep quality index , hospital anxiety and depression scale , quality of life (healthcare) , spirometry , physical therapy , psychiatry , insomnia , asthma , sleep quality , nursing , lung , economics , macroeconomics
Background Anxiety and depression might frequently affect bronchiectasis patients, but data in Chinese patients, including their association with disease severity assessed with Bronchiectasis Severity Index (BSI) and FACED score, are limited. Objective To investigate the rate, risk factors, association with disease severity and impact of anxiety and depression on health‐related quality of life (HRQoL) in adult outpatients with steady‐state bronchiectasis. Methods This cross‐sectional study included 163 outpatients (102 females; mean age, 45.8 years) and 80 healthy subjects (47 females; mean age, 47.1 years). Demographic, clinical indices, radiology, spirometry, aetiology, sputum bacteriology, Hospital Anxiety and Depression Scales (HADS), Pittsburgh Sleep Quality Index (PSQI) and St. George's Respiratory Questionnaire (SGRQ) were assessed. Results Patients with steady‐state bronchiectasis had a higher rate of depression (HADS‐depression >7) (30.1% vs 10.0%, P = .001) and anxiety (HADS‐anxiety >7; 39.9% vs 6.3%, P < .001) compared with healthy subjects. Notably, no significant differences in the rate of anxiety and depression were found across different disease severity, assessed with BSI and FACED score (all P > .05). In multivariate model, factors associated with anxiety included younger age (OR = 1.05), education below college graduate (OR = 4.55) and sleep disturbance (PSQI ≥ 6; OR = 2.95); whereas sleep disturbance was the sole factor associated with depression (OR = 5.98). Patients with either depression or anxiety had more markedly impaired HRQoL affecting most domains than those without. Conclusions Anxiety and depression are common in bronchiectasis and can negatively affect HRQoL, but not related to disease severity. Prompt assessment and treatment of these mental disorders, regardless of bronchiectasis severity, are advocated and might improve HRQoL.