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Assessment of anxiety and depression in COPD patients-A pilot study.

COPD is a chronic multisystem disorder with various co morbidities. Smoking is a major risk factor. It’s etiology and multisystem effects may contribute to depression and anxiety. Interplay of various factors along with gender, socioeconomic, educational and marital status also do contribute to depression and anxiety in COPD. Unfortunately, Evaluation of anxiety and depression are often neglected in patients with COPD attending outpatient department (OPD) which may further effect their quality of life .This study was conducted to evaluate patients of COPD attending OPD for presence of depression and anxiety and various risk factors contributing .The study included 121 subjects (with smoking history) attending OPD of TB and Chest Diseases. Depression and anxiety were evaluated using Becks Depression Inventory (BDI) and Hamilton Anxiety Scale (HAS) respectively. Odds ratio was used to analyze the data. Depression was found in 69(57.02%) cases and anxiety in 44(36.37%) subjects . As per Hamilton Anxiety Scale (HAS) 4(9.09%), 12(27.27%) and 28(63.64%) were having mild, moderate and severe anxiety respectively (out of 44 anxiety cases). Similarly, in depressive subjects: 5(7.25%) were having minimal depression whereas 10(14.5%), 20(28.98%) and 34(14.50%) subjects suffered from mild, moderate and severe depression respectively. The probability of having depression was more in male gender (OR 1.325, CI:1.002-1.753), lower education class (OR 1.197,CI:0.734-1.951), higher social class (OR 1.153,CI:0.703-1.889), single marital status (OR 1.665,CI:0.754-3.677) and cases residing in urban locality(OR 1.346,CI:1.006-1.8). Probability of having anxiety was more in female gender (OR 1.667,CI: 1.023-2.714), rural locality (OR 1.260,CI:0.780-2.035), higher education (OR 1.034,CI:0.790-1.354), upper socioeconomic status (OR 1.670,CI:1.045-2.671) and marital status being single(OR 1.458,CI:0.687-3.097). Some factors play more important role in causing anxiety and depression than others and interplay of these factors in turn contribute to anxiety and depression in COPD cases. Thus proper identification and redressal of these factors will help in better management of COPD.

Author(s): Shah Mohammad Abbas Waseem, Mobarak Hossain, S A Azmi, S Aijaz Abbas Rizvi,Zuber Ahmad, Sabahat H Zaidi