VolumeVol. 53 • Number No. 1 • January - March 2015 Back

Case Report

​​​​​​​Prevalence of Anxiety and Depression Among Filipino Patients with Chronic Obstructive Pulmonary Disease: A Multi-Center Study

Authors: Sue Kimberly M. Tan, Jubert P. Benedicto, Joel M. Santiaguel

DOI: 10.65564/pjim.f84bdc7109

Date of Publication: March 2015


Abstract

Background: One under-explored area in chronic obstructive pulmonary disease (COPD) patients is anxiety and/or depression, which may have negative impact in the patients’ condition. This is possibly the first study to possibly assess the burden of anxiety and depression in COPD patients in the Philippines.

Study Design: This is a prospective descriptive survey in three tertiary care hospitals in Manila, Philippines.

Participants: A total of 204 patients were enrolled in the study with the following inclusion criteria: Filipino patients who are aged more than or equal to 40 years with a diagnosis of COPD (documented post-bronchodilator FEV1/FVC ratio less than 0.7) by a physician seen at the outpatient clinics of three tertiary care hospitals with no primary diagnosis of asthma, no previous lung volume reduction surgery, lung transplantation or pneumonectomy and at least finished Grade 2 education.

Exclusion criteria include pregnant patients and patients previously diagnosed to have an anxiety, depression, or on any anti-depressant medications.

Methods: Descriptive statistics was obtained with frequency and percentages of the demographic and physiologic variables in the study by tabulation and graph. The prevalence of anxiety and depression was determined by calculating the percentage of each patient with a score of 8 or higher on the Hospital Anxiety and Depression Scale (HADS) with validated Tagalog version, respectively.

Results: The prevalence of anxiety in Filipino COPD patients is 47.55%. The prevalence of depression in Filipino COPD patients is 31.37%.

Conclusion: The prevalence of depression in Filipino COPD patients is comparable to the prevalence of depression from other general medical conditions nationwide according to the study of Batar (31.37% vs. 31%). Anxiety is slightly more prevalent in COPD from other general medical conditions (47.55% vs. 36%). A study on the risk factors of anxiety and depression among Filipino COPD patients is recommended.

Keywords: prevalence, anxiety, depression, COPD


References

  1. Maurer J, Rebbapragada V, Borson S, et al. Anxiety and Depression in COPD: Current Understanding, Unanswered Questions, and Research Needs. Chest, 134 (4): 43S–56S, 2008.
  2. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med, 16: 606–613, 2001.
  3. Weissman MM, Sholomskas D, Pottenger M, et al. Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol, 106: 203–214, 1977.
  4. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res, 17: 37–49, 1982.
  5. Zung WW. A self-rating depression scale. Arch Gen Psychiatry, 12: 63–70, 1965.
  6. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand, 67: 361–370, 1983.
  7. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther, 33: 335–343, 1995.
  8. Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry, 4: 561–571, 1961.
  9. Solano JP, Gomes B, Higginson IJ. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage, 31: 58–69, 2006.
  10. Gudmundsson G, Gislason T, Janson C, et al. Depression, anxiety and health status after hospitalisation for COPD: a multicentre study in the Nordic countries. Respir Med, 100: 87–93, 2006.
  11. Yohannes AM. Depression and COPD in older people: a review and discussion. Br J Community Nurs, 10: 42–46, 2005.
  12. Andenaes R, Kalfoss MH, Wahl A. Psychological distress and quality of life in hospitalized patients with chronic obstructive pulmonary disease. J Adv Nurs, 46: 523–530, 2004.
  13. Andenaes R, Kalfoss MH. Psychological distress in hospitalized patients with chronic obstructive pulmonary disease. Eur J Epidemiol, 19: 851–859, 2004.
  14. Dowson C, Laing R, Barraclough R, et al. The use of the Hospital Anxiety and Depression Scale (HADS) in patients with chronic obstructive pulmonary disease: a pilot study. N Z Med J, 114: 447–449, 2001.
  15. Hayashi Y, Senjyu H, Iguchi A, et al. Prevalence of depressive symptoms in Japanese male patients with chronic obstructive pulmonary disease. Psychiatry Clin Neurosci, 65(1): 82-88, 2011.
  16. Zhang MW, Ho RC, Cheung MW, et al. Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression. Epub, 33(3): 217-223, 2011.
  17. Batar MI. Prevalence of depression and anxiety among the medically ill Filipinos. 2011. Unpublished.
  18. Fan VS, Ramsey SD, Giardino ND, et al. Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease. Arch Intern Med, 167: 2345–2353, 2007.
  19. Kunik ME, Roundy K, Veazey C, et al. Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest, 127: 1205–1211, 2005.
  20. Kim HF, Kunik ME, Molinari VA, et al. Functional impairment in COPD patients: the impact of anxiety and depression. Psychosomatics, 41: 465–471, 2000.
  21. Kaneda R, Senjyu H, Iguchi A, et al. Factors that Impact Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease. J Phys Ther Sci, 23: 927-931, 2011.