Evaluation of Psychological Status in Patients with Asthma and COPD
Abstract
Chronic obstructive pulmonary disease (COPD) and asthma are major public health problems, which seems to have close association with psychiatric disorders. The present study was conducted to compare the psychological status between asthmatic and COPD patients and clarify the relationship with severity of pulmonary obstruction.
This cross-sectional study was planned to compare the psychological status in 67 stable obstructive lung patients (17 asthma, 24 asthmatic bronchitis and 26 COPD) referred to respiratory clinic of Ghaem hospital and 33 healthy controls, in Mashhad city, north east of Iran. Severity of pulmonary obstruction was determined based on GOLD criteria. “Beck Depression Inventory”, “Hamilton Anxiety Rating Scale” and “SCL-90-R” questionnaires were used to determine the psychological status.
Prevalence of general psychopathology in asthma, COPD, asthmatic bronchitis and control groups were 64.7%, 42.3%, 33.3% and 36.4% respectively. Psychological status was directly related to severity of pulmonary obstruction (p=0.048), Prevalence of depression in asthmatic, COPD and asthmatic bronchitis groups were 66.7%, 54.2% and 44.4% respectively. Depression score was related to severity of pulmonary obstruction (p=0.000).Prevalence of anxiety in asthma, COPD and asthmatic bronchitis were 46.7%, 45.8% and 40.7% respectively. Anxiety score was related to marital status and satisfaction with incomeAsthmatic and COPD patients are at equal risk of developing psychiatric disorders and both require psychological evaluations in respiratory clinics. Therapists must pay more attention to patients with severe pulmonary disease.
1. Masoli M, Fabian D, Holt S, Beasley R. Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee Report. Allergy 2004; 59(5):469-78.
2. Murphy SL. Deaths: Final data for 1998. Natl Vital Stat Rep 2000; 48(11):1-105.
3. Mannino DM. COPD: Epidemiology, prevalence, morbidity and mortality, and disease eterogeneity. Chest 2002; 121(5):121-6.
4. Beck AT, Beck RW. Screening depressed patients in family practice. Postgrad Med 1972; 52(6):81-5.
5. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian- language version of the Beck Depression Inventory– Second Edition: BDI-II-PERSIAN. Depress Anxiety 2005; 21(5):185-92.
6. Beck AT. Depression: Causes and Treatment.Philadelphia: University of Pennsylvania Press, 2006.
7. Bagby RM, Ryder AG, Schuller DR, Marshall MB. "The Hamilton Depression Rating Scale: has the gold standard become a lead weight?" Am J Psychiatry 2004;161(12):2163-77.
8. Hamilton A. Diagnosis and rating of anxiety. Br J Psychiatry 1969; 3:76-9.
9. Kavyani H, Mossavi AS, Mohit A. Psychological Scales and Interviews (Farsi). Tehran, Iran: Sana Publications 2001;179-205.
10. SCL-90-R(Symptom Checklist-90-Revised). Available at: http://www.pearsonassessments.com/scl90.aspx.accessed Feb12, 2009.
11. Hardt J, Gerbershagen HU, Franke P. The symptom check-list, SCL-90-R: its use and characteristics in chronic pain patients. Eur J Pain 2000; 4(2):137-48.
12. Schmitz N, Hartkamp N, Franz M, Buse S, Karig R, Tress W. Properties of the Symptom Check List (SCL-90-R) in a psychosomatic consultation-liaison setting. Psychol Rep 2002; 90(3 Pt 2):1201-7.
13. Wagena E J, Arrindell WA, Wouters EFM, van Schayck CP. Are patients with COPD psychologically distressed? Eur Respir J 2005; 26(2):242-8.
14. Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire. Int J Geriatr Psychiatry 2000; 15(12):1090–6.
15. Schmitz N, Kruse J, Heckrath C, Alberti L, Tress W.Diagnosing mental disorders in primary care: the General Health Questionnaire (GHQ) and the Symptom Check List (SCL-90-R) as screening instruments. Soc Psychiatry Psychiatr Epidemiol 1999; 34(7):360-6.
16. Scott K, Von Korff M, Ormel J, Zhang MY, Bruffaerts R, Alonso J, et al. Mental disorder among adults with asthma: results from the World Mental Health Survey. Gen Hosp Psychiatry 2007; 29(2):123-33.
17. Lavoie KL, Bacon SL, Barone S, Cartier A, Ditto B, Labrecque M. What is worse for asthma control and quality of life: depressive disorders, anxiety disorders, or both? Chest 2006; 130(4):1039-47.
18. Lavoie KL, Cartier A, Labrecque MI, Bacon SL, Lemière C, Malo JL, et al. Are psychiatric disorders associated with worse asthma control and quality of life in asthma patients? Respir Med 2005; 99(10):1249-57.
19. Campbell DA, Yellowless PM, McLennan G, Coates JR, Frith PA, Gluyas PA, et al. Psychiatric and medical features of near fatal asthma. Thorax. 1995; 50(3):254-59.
20. Heaney LG, Conway E, Kelly C, Gamble J. Prevalence of psychiatric morbidity in a difficult asthma population: relationship to asthma outcome. Respir Med 2005;99(9):1152.
21. Wang G, Wang L, Szczepaniak WS, Xiong ZY, Wang L, Zhou T, et al. Psychological status in uncontrolled asthma is not related to airway hyper-responsiveness. J Asthma 2010; 47(1):93-9.
22. Goodwin RD, Jacobi F, Thefeld W. Mental disorders and asthma in the community. Arch Gen Psychiatry 2003;60(11):1125-30.
23. Wagena E J, Arrindell WA, Wouters EFM, van Schayck CP. Are patients with COPD psychologically distressed? Eur Respir J 2005; 26(2):242-8.
24. Balcells E, Gea J, Ferrer J, Serra I, Orozco-Levi M, de Batlle J, et al. Factors affecting the relationship between psychological status and quality of life in COPD patients. Health Qual Life Outcomes 2010; 8:108.
25. Janssen DJ, Spruit MA, Leue C, Gijsen C, Hameleers H, Schols JM, et al. Symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation. Chron Respir Dis 2010; 7(3):147-57.
26. Yohannes AM, Baldwin RC, Connolly MJ. Mood disorders in elderly patients with chronic obstructive pulmonary disease. Rev Clin Gerontol 2000; 10:193–202.
27. Carvalho NS, Ribeiro PR, Ribeiro M, Nunes MP, Cukier A, Stelmach R. Comparing asthma and chronic obstructive pulmonary disease in terms of symptoms of anxiety and depression. J Bras Pneumol 2007; 33(1):1-6.
28. Omachi TA, Katz PP, Yelin EH, Gregorich SE, Iribarren C, Blanc PD, et al. Depression and health-related quality of life in chronic obstructive pulmonary disease. Am J Med 2009; 122(8):778.
29. Martínez-Rivera C, Vennera Mdel C, Cañete C, Bardagí S, Picado C. Psychological profile of patients with bronchial asthma and functional dyspnea: a comparison with a non-asthmatic population and impact on the disease. Arch Bronconeumol 2011; 47(2):73-8.
30. Kühl K, Schürmann W, Rief W. Mental disorders and quality of life in COPD patients and their spouses. Int J Chron Obstruct Pulmon Dis 2008; 3(4):727-36.
31. Cooper CL, Parry GD, Saul C, Morice AH, Hutchcroft BJ, Moore J, et al. Anxiety and panic fear in adults with asthma: prevalence in primary care. BMC Fam Prat 2007;8:62.
32. Wilson DH, Appleton SL, Taylor AW, Tucker G, Ruffin RE, Wittert G, et al. Depression and obesity in adults with asthma: multiple comorbidities and management issues. Med J Aust 2010; 192(7):381-3.33. Nowobilski R, Furgał M, Polczyk R, de Barbaro B,Szczeklik A. Gender gap in psychogenic factors may affect perception of asthma symptoms. J Investig Allergol Clin Immunol 2011; 21(3):193-8.
34. Miedinger D, Lavoie KL, L'Archevêque J, Ghezzo H,Zunzunuegui MV, Malo JL. Quality of life, psychological, and cost outcomes 2 years after diagnosis of occupational asthma. J Occup Environ Med 2011;53(3):231-8.
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Issue | Vol 11, No 1 (2012) | |
Section | Articles | |
Keywords | ||
Anxiety Asthma Chronic obstructive pulmonary diseases Depression Psychopathology |
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