The Occurrence And Influencing Factors Of Anxiety And Depression In Inpatients With Chronic Obstructive Pulmonary Disease

ObjectiveThis paper investigated the occurrence of anxiety and depression in inpatients with COPD, and explored the related factors, especially the effect of the perceived stress and emotion regulation strategies (emotion regulation and the components of ruminative responses) on anxiety and depression in inpatients with COPD. It provided the basis for the mechanism of anxiety and depression,and provided the basis for effective prevention and intervention of anxiety and depression symptoms.MethodsTotally 94 COPD inpatients from a first-class hospital in Shandong province were selected. They were assessed with the general information questionnaire, 10-item version of the Perceived Stress Scale (PSS-10), Ruminative Responses Scale (RRS), Emotion Regulation Questionnaire (ERQ), hospital anxiety and Depression Scale (HADS). Generally, the patients were considered anxiety positive and depression positive, if their HADS-A subscale and HADS-D subscale were more than 9 points respectively. The influencing factors of anxiety and depression in inpatients with COPD were analyzed by hierarchical linear regression.Results1. Anxiety scores in COPD patients are 6.82±3.75, the depression scores are 6.51± 4.64, the positive rate of anxiety is 27.7%, the positive rate of depression is 27.7%, patients with comorbid anxiety and depression account for 18.1%.2. The influencing factors of anxiety symptom(1) One-way ANOVA results show that the anxiety scores have no significant difference between different demographic characteristics (all P>0.05).(2) One-way ANOVA results show that the anxiety scores in patients who were in hospital twice a year or more were significantly higher than those twice a year, (P=0.045), once a year (P=0.005). The anxiety scores between other disease characteristics are not significant statistically (P>0.05).(3) The results of hierarchical linear regression of anxiety symptoms show that the standardized partial regression coefficients of perceived stress, symptom rumination on anxiety scores are 0.414 (P< 0.001),0.512 (P=0.001) respectively, and explain 61.5% of anxiety variance. And the effect of other emotion regulation strategies on anxiety symptom is not significant.3. The influencing factors of depressive symptom(1) One-way ANOVA results show that patients aged 71.5 years or older have significantly higher HADS depression scores than those under the age of 71.5 years (P=0.037). And the depression scores have no significant difference between other different demographic characteristics (all P>0.05).(2) One-way ANOVA results show that the depression scores between the kinds of chronic disease are close to significant statistically (P=0.052). And the depression scores between other disease characteristics are not significant statistically (P>0.05).(3) The results of hierarchical linear regression of depression symptoms show that the standardized partial regression coefficients of perceived stress, symptom rumination on depression scores are 0.315 (P=0.004),0.480 (P=0.013) respectively, and explain 35.1% of depression variance. And the effect of other emotion regulation strategies on anxiety symptom is not significant.Conclusions1. Anxiety and depression is prominent in inpatients with COPD, the medical staffs should pay attention to the intervention targeted to related factors to improve the psychological status of inpatients with COPD.2. The more the number of COPD hospitalization, the more prone to anxiety.3. The older and comorbid chronic diseases are the influencing factors of depression symptom.4. Patients with higher levels of perceived stress and more serious symptom ruminant exhibit higher anxiety and depression scores.