Correlated Factors And Treatment Of Anxiety And Depression In Patients With Chronic Obstructive Pulmonary Disease

Characterized by persistent respiratory symptoms and restricted airflow,chronic obstructive pulmonary disease(COPD)is a common disease that can be prevented and treated.Airway and intrapulmonary tissue are mainly involved and significant extrapulmonary effects can be expected.In recent years,the role mental status plays in the complications of COPD has been paid great attention and has caused great concern.Among all the mental disorders caused by COPD,anxiety and depression are rather serious extrapulmonary manifestations.However,there has been no definite conclusion about the correlated factors and effective treatment for COPD patients with anxiety or depression.This study analyzed the correlated factors of anxiety and depression of the patients in stable phaseof high-riskCOPD,and studied the therapeutic effect ofSeretide and Deanxit.Objective: To investigate the correlated factors associated with anxiety and depression in patients with COPD and explore the clinical treatment methods.Methods: A total of 120 patients in stable phase of COPD at high risk of acute exacerbationfrom outpatient or inpatient were recruited.For each patient,a pulmonary function test was performed to detect FVC,FEV1,FEV1/FVC and FEV1%pred.The demographic data,information of lifestyle,mMRC dyspnea scores,SAS and SDS scores were collected through questionnaires.The 6 minute walking distance(6MWD)was measured and the BODE index was calculated.Patients were divided into simple COPD group,COPD with anxiety group(SAS score ?50 without SDS score?53)and COPD with depression group(SDS score?53 with or withoutSAS score ?50).The differences of sex,age,culture,economic condition,solitude,smoking history,drinking history,course of disease and BODE index between COPD with anxiety and simple COPD,COPD with depression andsimpleCOPD were compared.The COPD patients with anxiety and the COPD patients with depression received Seretide for four weeks,pulmonary function,6MWD,BODE index,mMRC dyspnea scores,SAS and SDS scores were measured.In the following four weeks,the COPD patients with anxiety and the COPD patients with depression received Seretide and Deanxit,pulmonary function,6MWD,BODE index,mMRC dyspnea scores,SAS and SDS scores were measured again,compared with those before treatment and thoseafter the treatment with Seretide only.Results:1.Logistic Regression revealed that anxiety was independently correlated with solitude and BODE index.The OR of solitude was 3.975,95% CI was 1.077-14.670(P<0.05).The OR of the BODE index was 1.569,95% CI was 1.022-2.411(P<0.05).2.Logistic Regression revealed that depression was independently correlated with solitude,course of the disease and BODE index.The OR of solitude was 3.780,95% CI was 1.084-13.182(P<0.05).The OR of course of the disease was 3.074,95% CI was 1.138-8.306(P<0.05).The OR of the BODE index was 1.357,95% CI was 1.011-1.822(P<0.05).3.For the COPD patients with anxiety: After the treatment withSeretide,FEV1%pred and 6MWD were increased and showed significant differencescompared with those before treatment(P<0.05),however,there were no statistical differences in mMRC dyspnea scores,BMI,BODE index and SAS score(P>0.05).After the treatment with Seretide and Deanxit,FEV1%pred and 6MWD were increased,mMRC dyspnea scores,BODE index and SAS scores were decreased(P<0.05),but BMI was not significantly different(P>0.05)compared with that before treatment.The mMRC dyspnea scores,BODE index and SAS score were decreased,significantly different after the treatment with Seretide and Deanxit compared with those after the treatment with Seretide only(P<0.05),while FEV1%pred,6MWD and BMI were not significantly different(P>0.05).4.For the COPD patients with depression: After the treatment withSeretide,FEV1%pred and 6MWD were increased and showed significant differencescompared with those before treatment(P<0.05),however,there were no statistical differences in mMRC dyspnea scores,BMI,BODE index and SDS score(P>0.05).After the treatment with Seretide and Deanxit,FEV1%pred and 6MWD were increased,mMRC dyspnea scores,BODE index and SDS scores were decreased(P<0.05),but BMI was not significantly different(P>0.05)compared with that before treatment.The mMRC dyspnea scores,BODE index and SDS score were decreased,significantly different after the treatment with Seretide and Deanxit compared with those after the treatment with Seretide only(P<0.05),while FEV1%pred,6MWD and BMI were not significantly different(P>0.05).Conclusions:1.The prevalence of anxiety or depression in COPD patients was high.Anxiety was independently correlated with solitude and BODE index.Depression was independently correlated with solitude,course of the disease and BODE index.Among COPD patients,it is very important to pay attention to solitude,course of disease and BODE index for early screening of anxiety and depression.2.Being able to reduce BODE index as well as alleviate anxiety and depression symptoms in COPD patients,Seretide and Deanxit could be considered to have wide popularization and application prospects...