The effectiveness of pulmonary rehabilitation on chronic obstructive pulmonary disease patients with concurrent presence of comorbid depression and anxiety - 11/05/22
, Richard Casaburi b, Sheila Dryden c, Nicola A. Hanania dAbstract |
Background |
We examined the prevalence of comorbid depression and anxiety in patients with chronic obstructive pulmonary disease (COPD) and their response to eight-weeks of pulmonary rehabilitation (PR).
Methods |
Seven hundred thirty four patients with clinically stable COPD completed an eight-week outpatient multidisciplinary PR, comprising 2-h (1-h exercise and 1-h education) per/week. Depression and anxiety, exercise capacity, quality of life (QOL), and dyspnea were measured pre- and post-PR by the incremental shuttle walk test (ISWT), St. George's Respiratory Questionnaire (SGRQ), and modified Medical Research Council (mMRC) scale, respectively. The Depression Anxiety Stress Scale (DASS-21) was completed and patients classified as having clinically significant comorbid anxiety and depression, anxiety alone, depression alone, or with neither.
Results |
The mean (SD) age of patients was 71 (8.8) years, and 51% were men. Prevalence of pre-PR comorbid depression and anxiety was 34%, anxiety alone 20%, depression alone 5% and neither 41%. The prevalence of stress was 59%. In patients with anxiety and depressive symptoms, total SGRQ score improved from 64.9 (13.8) pre-PR to 50.1 (17.2) post PR (p < 0.001), mMRC score improved from 3.4(1.0) pre-PR to 2.8 (1.1) post PR (p < 0.001), and ISWT distance walked increased from 188.6 (117.6) pre-PR to 248.6 (149.1) post PR, p < 0.001.
Conclusion |
One in three patients with COPD suffer from comorbid depression and anxiety with a high level of disease burden, reflected by symptoms of elevated dyspnea and impaired QOL. PR improves QOL and exercise capacity, and reduces dyspnea in patients with COPD and comorbid depression and anxiety.
Le texte complet de cet article est disponible en PDF.Take home points |
• | One in three patients with COPD suffer from comorbid depression and anxiety. |
• | Pulmonary rehabilitation (PR) improves quality of life and increase exercise capacity in patients with comorbid anxiety and depression. |
• | Depression and anxiety group showed clinically significant improvement in stress and dyspnea. |
• | The efficacy of PR was greater in depression anxiety group, compared to depression alone or anxiety alone. |
• | Three fifths of COPD patients had increased burden of stress and related with elevated symptoms of depression and anxiety. |
Keywords : COPD, Depression and anxiety, Stress, Quality of life, Exercise capacity, Pulmonary rehabilitation
Abbreviations : COPD, DASS-21, PR, mMRC, MCID, QOL, SGRQ, ISWT
Plan
Vol 197
Article 106850- juin 2022 Retour au numéro
Article précédent
- Adherence and persistence to once-daily single-inhaler versus multiple-inhaler triple therapy among patients with chronic obstructive pulmonary disease in the USA: A real-world study
- David Mannino, Michael Bogart, Benjamin Wu, Guillaume Germain, François Laliberté, Sean D. MacKnight, Young Jung, Marjorie Stiegler, Mei Sheng Duh
- Chronic obstructive pulmonary disease is associated with a higher risk of functional gastrointestinal disorders
- Yu-Chi Chiu, Wei-Pin Chang, Gau-Jun Tang, Tzuo-Yun Lan, Kang-Yun Lee, Vincent Yi-Fong Su
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?