The Investigation of Anxiety and Depression in COPD Patients

Aim: This study aimed to determine the prevalence of anxiety and depression among patients with chronic obstructive pulmonary disease (COPD) and examine the relationship between psychological symptoms and dyspnea severity across Global Initiative for Obstructive Lung Disease (GOLD) defined COPD stages. Methods: A cross-sectional study was conducted between July 2018 and July 2019 at a pulmonary diseases outpatient clinic. Sixty-one patients with COPD were evaluated using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), and the Modified Medical Research Council (mMRC) dyspnea scale. Results: Anxiety and depression scores increased significantly with higher mMRC grades (BAI: p = 0.012; BDI: p = 0.018). Using established cut-offs, clinically relevant anxiety was present in 9.8% (BAI ≥16; n = 6) and 8.2% (HADS-A ≥10; n = 5) of the patients. Clinically relevant depression was present in 11.5% (BDI ≥ 17; n = 7) and 26.2% (HADS-D ≥ 7; n = 16) of the patients. Dyspnea severity (mMRC) was moderately associated with anxiety scores (Spearman’s ρ = 0.407, p = 0.001) and had a weaker, borderline association with depressive symptoms (ρ = 0.251, p = 0.051). Smoking status was correlated with depressive symptoms (BDI: p = 0.025; HADS-D: p = 0.012). Pack-years correlated weakly but significantly with anxiety (ρ = 0.371, p = 0.005) and depression (ρ = 0.309, p = 0.022). No association was detected between FEV1% and the psychological scale scores. Conclusion: Dyspnea severity and smoking exposure were associated with greater psychological distress in patients with COPD. These findings support the integration of routine psychological screening into comprehensive COPD management strategies.