Current situation and influencing factors of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

PEI Wenjing ¹ , LI Ping ¹ , WANG Ruowen ¹ , LIU Hui ¹ , LIU Pengcheng ¹ , GAO Lei ¹ , MA Changxiu ¹ , ZHENG Ling ¹ , ZHANG Xiwei ² , SUN Xiao ² ,  ZHAO Dahai ¹ ,  YE Jing ¹

1. Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, P. R. China;
2. Artificial Intelligence Research Institute of Hefei Comprehensive National Science Center (Anhui Artificial Intelligence Laboratory), Hefei, Anhui 230092, P. R. China;

Corresponding author：

ZHAO Dahai, Email: zhaodahai@ahmu.edu.cn; YE Jing, Email: plowchan@126.com

Keywords：

Acute exacerbation of chronic obstructive pulmonary disease; anxiety; depression; chronic obstructive pulmonary disease assessment test; platelet to lymphocyte ratio

DOI：

10.7507/1671-6205.202403015

Video：

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Objective To investigate the current situation of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze the related influencing factors. Methods A questionnaire survey was conducted among AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University from August 2022 to October 2023. The survey included basic demographic information, anxiety and depression scores, quality of life and dyspnea symptoms in the AECOPD patients. The clinical data of patients in the electronic medical record system were also collected. According to the anxiety score or depression score, the patients were divided into an anxiety group and a non-anxiety group, or a depression group and a non-depression group. The indicators between two groups were compared and the influencing factors were analyzed. Results Among the 164 patients with AECOPD, 123 patients (75.0%) were complicated with anxiety, 125 patients (76.2%) were complicated with depression, and 105 patients (64.0%) were complicated with anxiety and depression. Education level, place of residence, monthly income, smoking index, and chronic obstructive pulmonary disease assessment test (CAT) score were associated with AECOPD and anxiety (P<0.05). Higher CAT score was an independent risk factor for anxiety in the patients with AECOPD. Residence, monthly income, smoking index, CAT score, modified British Medical Research Council (mMRC) dyspnea questionnaire rating, actual bicarbonate, neutrophilic granulocyte percentage (NEU%), lymphocyte percentage (LYM%), basophile percentage (BASO%), alkaline phosphatase, total carbon dioxide concentration, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were associated with AECOPD and depression (P<0.05). Among them, higher CAT score and PLR value were independent risk factors of AECOPD and depression. Conclusion Anxiety and depression have higher prevalence in AECOPD patients, and the influencing factors include quality of life, dyspnea symptoms, education level, place of residence, monthly income, smoking index, acid base balance, NEU%, LYM%, BASO%, NLR和PLR, etc.

Citation： PEI Wenjing, LI Ping, WANG Ruowen, LIU Hui, LIU Pengcheng, GAO Lei, MA Changxiu, ZHENG Ling, ZHANG Xiwei, SUN Xiao, ZHAO Dahai, YE Jing. Current situation and influencing factors of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2024, 23(7): 457-464. doi: 10.7507/1671-6205.202403015 Copy

1.	《2023GOLD慢性阻塞性肺疾病诊断、管理及预防全球策略》COPD急性加重的定义及管理. 实用心脑肺血管病杂志, 2023, 31(10): 5.
2.	彭慧, 龚桂姿. COPD急性加重期合并焦虑抑郁研究进展. 全科护理, 2023, 21(4): 474-477.
3.	Wu D, Zhao X, Huang D, et al. Outcomes associated with comorbid anxiety and depression among patients with stable COPD: a patient registry study in China. J Affect Disord, 2022, 313: 77-83.
4.	汤毓华, 张明园. 汉密顿焦虑量表(HAMA). 上海精神医学, 1984(2): 64-65.
5.	汤毓华, 张明园. 汉密顿抑郁量表(HAMD). 上海精神医学, 1984(2): 61-64.
6.	Sciriha A, Lungaro-Mifsud S, Scerri J, et al. Health status of COPD patients undergoing pulmonary rehabilitation: a comparative responsiveness of the CAT and SGRQ. Chron Respir Dis, 2017, 14(4): 352-359.
7.	Huang J, Bian Y, Zhao Y, et al. The impact of depression and anxiety on chronic obstructive pulmonary disease acute exacerbations: a prospective cohort study. J Affect Disord, 2021, 281: 147-152.
8.	叶志鹏, 陈磊. 慢性阻塞性肺疾病合并焦虑抑郁的研究进展. 中国呼吸与危重监护杂志, 2019, 18(5): 491-494.
9.	Yao HM, Xiao RS, Cao PL, et al. Risk factors for depression in patients with chronic obstructive pulmonary disease. World J Psychiatry, 2020, 10(4): 59-70.
10.	Yohannes AM, Kaplan A, Hanania NA. Anxiety and depression in chronic obstructive pulmonary disease: recognition and management. Cleve Clin J Med, 2018, 85(Suppl 1): S11-S18.
11.	Bock K, Bendstrup E, Hilberg O, et al. Screening tools for evaluation of depression in Chronic Obstructive Pulmonary Disease (COPD). A systematic review. Eur Clin Respir J, 2017, 4(1): 1332931.
12.	丁静怡. 慢性阻塞性肺疾病合并焦虑抑郁的相关因素分析. 临床肺科杂志, 2018, 23(4): 690-693.
13.	Martínez-Gestoso S, García-Sanz MT, Carreira JM, et al. Impact of anxiety and depression on the prognosis of copd exacerbations. BMC Pulm Med, 2022, 22(1): 169.
14.	Volpato E, Toniolo S, Pagnini F, et al. The relationship between anxiety, depression and treatment adherence in chronic obstructive pulmonary disease: a systematic review. Int J Chron Obstruct Pulmon Dis, 2021, 16: 2001-2021.
15.	Tang T, Li Z, Lu X, Du J. Development and validation of a risk prediction model for anxiety or depression among patients with chronic obstructive pulmonary disease between 2018 and 2020. Ann Med, 2022, 54(1): 2181-2190.
16.	廖金花, 邹淑芹, 刘婉姿. 慢性阻塞性肺疾病女性患者合并抑郁的临床特点及危险因素. 中国当代医药, 2023, 30(27): 47-50.
17.	Taylor GM, Lindson N, Farley A, et al. Smoking cessation for improving mental health. Cochrane Database Syst Rev, 2021, 3(3): CD013522.
18.	Lou P, Chen P, Zhang P, et al. Effects of smoking, depression, and anxiety on mortality in COPD patients: a prospective study. Respir Care, 2014, 59(1): 54-61.
19.	Hyun MK, Lee NR, Jang EJ, et al. Effect of inhaled drugs on anxiety and depression in patients with chronic obstructive pulmonary disease: a prospective observational study. Int J Chron Obstruct Pulmon Dis, 2016, 11: 747-754.
20.	高瞻, 尹燕, 晏妮, 等. 慢性阻塞性肺疾病并发焦虑抑郁患者临床特征及风险评估. 中华肺部疾病杂志(电子版), 2022, 15(5): 625-629.
21.	陈颖越. 慢性阻塞性肺疾病患者并发焦虑的影响因素分析. 中国实用医药, 2023, 18(7): 32-36.
22.	Bahari H, Seifi N, Foroumandi E, et al. Dietary acid load, depression, and anxiety: results of a population-based study. BMC Psychiatry, 2023, 23(1): 679.
23.	Long J, Ouyang Y, Duan H, et al. Multiple factor analysis of depression and/or anxiety in patients with acute exacerbation chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2020, 15: 1449-1464.
24.	Özdin S, Böke Ö. Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in different stages of schizophrenia. Psychiatry Res, 2019, 271: 131-135.
25.	Arbel Y, Finkelstein A, Halkin A, et al. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis, 2012, 225(2): 456-460.
26.	Wang RH, Wen WX, Jiang ZP, et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage. Front Immunol, 2023, 14: 1115031.
27.	Mazza MG, De Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behav Immun, 2020, 89: 594-600.
28.	Vozoris NT, Wang X, Austin PC, et al. Serotonergic antidepressant use and morbidity and mortality among older adults with COPD. Eur Respir J, 2018, 52(1): 1800475.
29.	Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clin Chest Med, 2020, 41(3): 421-438.

1. 《2023GOLD慢性阻塞性肺疾病诊断、管理及预防全球策略》COPD急性加重的定义及管理. 实用心脑肺血管病杂志, 2023, 31(10): 5.
2. 彭慧, 龚桂姿. COPD急性加重期合并焦虑抑郁研究进展. 全科护理, 2023, 21(4): 474-477.
3. Wu D, Zhao X, Huang D, et al. Outcomes associated with comorbid anxiety and depression among patients with stable COPD: a patient registry study in China. J Affect Disord, 2022, 313: 77-83.
4. 汤毓华, 张明园. 汉密顿焦虑量表(HAMA). 上海精神医学, 1984(2): 64-65.
5. 汤毓华, 张明园. 汉密顿抑郁量表(HAMD). 上海精神医学, 1984(2): 61-64.
6. Sciriha A, Lungaro-Mifsud S, Scerri J, et al. Health status of COPD patients undergoing pulmonary rehabilitation: a comparative responsiveness of the CAT and SGRQ. Chron Respir Dis, 2017, 14(4): 352-359.
7. Huang J, Bian Y, Zhao Y, et al. The impact of depression and anxiety on chronic obstructive pulmonary disease acute exacerbations: a prospective cohort study. J Affect Disord, 2021, 281: 147-152.
8. 叶志鹏, 陈磊. 慢性阻塞性肺疾病合并焦虑抑郁的研究进展. 中国呼吸与危重监护杂志, 2019, 18(5): 491-494.
9. Yao HM, Xiao RS, Cao PL, et al. Risk factors for depression in patients with chronic obstructive pulmonary disease. World J Psychiatry, 2020, 10(4): 59-70.
10. Yohannes AM, Kaplan A, Hanania NA. Anxiety and depression in chronic obstructive pulmonary disease: recognition and management. Cleve Clin J Med, 2018, 85(Suppl 1): S11-S18.
11. Bock K, Bendstrup E, Hilberg O, et al. Screening tools for evaluation of depression in Chronic Obstructive Pulmonary Disease (COPD). A systematic review. Eur Clin Respir J, 2017, 4(1): 1332931.
12. 丁静怡. 慢性阻塞性肺疾病合并焦虑抑郁的相关因素分析. 临床肺科杂志, 2018, 23(4): 690-693.
13. Martínez-Gestoso S, García-Sanz MT, Carreira JM, et al. Impact of anxiety and depression on the prognosis of copd exacerbations. BMC Pulm Med, 2022, 22(1): 169.
14. Volpato E, Toniolo S, Pagnini F, et al. The relationship between anxiety, depression and treatment adherence in chronic obstructive pulmonary disease: a systematic review. Int J Chron Obstruct Pulmon Dis, 2021, 16: 2001-2021.
15. Tang T, Li Z, Lu X, Du J. Development and validation of a risk prediction model for anxiety or depression among patients with chronic obstructive pulmonary disease between 2018 and 2020. Ann Med, 2022, 54(1): 2181-2190.
16. 廖金花, 邹淑芹, 刘婉姿. 慢性阻塞性肺疾病女性患者合并抑郁的临床特点及危险因素. 中国当代医药, 2023, 30(27): 47-50.
17. Taylor GM, Lindson N, Farley A, et al. Smoking cessation for improving mental health. Cochrane Database Syst Rev, 2021, 3(3): CD013522.
18. Lou P, Chen P, Zhang P, et al. Effects of smoking, depression, and anxiety on mortality in COPD patients: a prospective study. Respir Care, 2014, 59(1): 54-61.
19. Hyun MK, Lee NR, Jang EJ, et al. Effect of inhaled drugs on anxiety and depression in patients with chronic obstructive pulmonary disease: a prospective observational study. Int J Chron Obstruct Pulmon Dis, 2016, 11: 747-754.
20. 高瞻, 尹燕, 晏妮, 等. 慢性阻塞性肺疾病并发焦虑抑郁患者临床特征及风险评估. 中华肺部疾病杂志(电子版), 2022, 15(5): 625-629.
21. 陈颖越. 慢性阻塞性肺疾病患者并发焦虑的影响因素分析. 中国实用医药, 2023, 18(7): 32-36.
22. Bahari H, Seifi N, Foroumandi E, et al. Dietary acid load, depression, and anxiety: results of a population-based study. BMC Psychiatry, 2023, 23(1): 679.
23. Long J, Ouyang Y, Duan H, et al. Multiple factor analysis of depression and/or anxiety in patients with acute exacerbation chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2020, 15: 1449-1464.
24. Özdin S, Böke Ö. Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in different stages of schizophrenia. Psychiatry Res, 2019, 271: 131-135.
25. Arbel Y, Finkelstein A, Halkin A, et al. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis, 2012, 225(2): 456-460.
26. Wang RH, Wen WX, Jiang ZP, et al. The clinical value of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI) for predicting the occurrence and severity of pneumonia in patients with intracerebral hemorrhage. Front Immunol, 2023, 14: 1115031.
27. Mazza MG, De Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behav Immun, 2020, 89: 594-600.
28. Vozoris NT, Wang X, Austin PC, et al. Serotonergic antidepressant use and morbidity and mortality among older adults with COPD. Eur Respir J, 2018, 52(1): 1800475.
29. Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clin Chest Med, 2020, 41(3): 421-438.

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