Psychiatric co-morbidity in patients admitted with acute exacerbation of chronic pulmonary disease and its relationship with symptom severity

Introduction: Patients with chronic pulmonary disease (CPD) often report symptoms affecting daily activities and quality of life, as well as symptoms of anxiety and depression. Objectives: To establish prevalence of symptoms of anxiety and depression in patients admitted with acute exacerbation of CPD, and its association with baseline MRC score. Methods: Data were analysed from a cohort of 389 patients (45% male) recruited to a single-blinded randomised control trial investigating pulmonary rehabilitation on rehospitalisation. Hospital Anxiety and Depression Scale (HADS) was used to measure symptom severity; score ≥11 considered abnormal. Baseline MRC dyspnoea score was used to measure breathlessness. Correlations used Pearson9s r and Spearman9s rho. Results: Patients had a mean age of 71.1 (SD=9.7 years), BMI 26.8 (SD=7.6), mean FEV1 54.7% predicted (SD=24.4), MRC score 3-5 (median=4 IQR=3-4). HADS data (n=323) showed 39% patients with abnormally high levels of anxiety and 26% with abnormally high levels of depression. During the trial there were 80 deaths, not significantly correlated with anxiety or depression. *p Conclusion There was high prevalence of anxiety and depression in the cohort. Higher MRC score was associated with increasing levels of anxiety and depression, though increasing age was associated with lower scores. Female gender was associated with higher scores of anxiety.