Association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease

OBJECTIVE

This was a single-centre, cross-sectional, observational study performed at a tertiary care hospital in India to study the association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease (COPD).

METHODS

A total of 59 clinically stable patients with COPD were assessed for disease severity, as per the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (2013). Psychiatric co-morbidities like anxiety disorders and depression were diagnosed by clinician-administered interview (as per the DSM-V criteria). Insomnia, anxiety disorders and depression, as well as quality of life were also assessed by self-rating scales including Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and St. George's Respiratory Questionnaire, respectively.

RESULTS

Depression was the commonest psychiatric co-morbidity affecting 32.2% of individuals. Patients with depression and anxiety disorders had higher score in COPD assessment test (p = 0.02 and p = 0.004, respectively), ISI (p < 0.001 and p = 0.01, respectively), and poorer quality of life (p < 0.001 and p = 0.02, respectively) compared with those without these conditions. Patients with severe symptoms of COPD were more likely to suffer from anxiety (p = 0.001), depression (p = 0.01), insomnia (p = 0.01), and have poor quality of life (p < 0.001). Patients in the GOLD-D (i.e. those at high risk and with more symptoms) group had poorer quality of life (p = 0.004) when compared with GOLD-A (low risk and less symptoms) and GOLD-C (high risk and less symptoms) groups.

CONCLUSIONS

Patients with psychiatric co-morbidities have severe symptoms of COPD and poor quality of life.

Association of panic disorder with quality of life among individuals with headache

OBJECTIVE

To study the association of panic disorder with severity of anxiety symptoms and quality of life among individuals presenting with headache.

METHODS

This was a single-centre, cross-sectional, observational, questionnaire-based study performed at the psychiatry outpatient department of a tertiary care hospital. Participants of both genders, aged between 18 and 60 years, and having headache as a presenting complaint for at least 3 months were evaluated for symptoms of panic disorder. The severity of headache was evaluated with the visual analogue scale and that of anxiety disorder with the Hamilton Anxiety Rating Scale (HAM-A). The quality of life was evaluated with the World Health Organization Quality of Life Scale brief version. Proportions of participants were compared using Chi-square test, and scores by Mann-Whitney test or Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons.

RESULTS

The frequency of panic disorder among patients with headache was 67%. Those with daily headache and panic disorder (with or without agoraphobia) showed higher HAM-A score and poorer quality of life than those with intermittent headache and without panic disorder, respectively.

CONCLUSIONS

Co-morbid panic disorder among patients with headache was associated with high anxiety score and poor quality of life.