Anxiety and depression in COPD patients and correlation with sputum and BAL cytology

Cuneyt Tetikkurt; Imran Ozdemir; Seza Tetikkurt; Nail Yılmaz; Turan Ertan; Nihal Bayar

doi:10.4081/mrm.2011.444

Anxiety and depression in COPD patients and correlation with sputum and BAL cytology

Authors

Cuneyt Tetikkurt Pulmonary Diseases Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul
Imran Ozdemir Pulmonary Diseases Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul
Seza Tetikkurt Pathology Department, Bagcılar Research and Training Hospital, Istanbul
Nail Yılmaz Pulmonary Diseases Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul,
Turan Ertan Psychiatry Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul
Nihal Bayar Pulmonary Diseases Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul

DOI: https://doi.org/10.4081/mrm.2011.444

Keywords:

Anxiety, bronchoalveolar lavage, BODE index, COPD, depression, GOLD

Abstract

Background and aims: Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD). The degree of lung function may not explain anxiety and depression. The aim of our study was to assess the psycholog- ical aspects of COPD, to test the BODE index (a composite score of body mass, obstruction, dyspnea and exercise capac- ity), and to evaluate the association between atypical cyto- logic findings of sputum, bronchoalveolar lavage (BAL) and the pyschological components of the disease.

Methods: COPD was classsified according to the GOLD stages based on forced expiratory volume in 1 second (FEV1) in 60 stable patients. The BODE index was calculated for grading COPD. The Hospital anxiety and depression (HAD) scale was used to appraise the anxiety and depression symptoms. Cytologic examination of sputum and BAL samples were per- formed in each patient. The cytologic findings were classified as normal, mild, moderate or severe atypia.

Results: The overall prevalance of anxiety and depression symptoms was 41.7% and 46.7% respectively. The prevalance of these symptoms increased with increasing BODE stages and correlated well with the severity of atypical BAL cytology results (p < 0.001). Dyspnea and reduced exercise capacity were the predominant mechanisms leading to anxiety and depression symptoms associated with COPD.

Conclusions: We conclude that the BODE index is superior to GOLD stratification for explaining anxiety and depression symptoms in COPD. BAL cytologic findings, which reflect the distal parenchymal lung structure, correlated significantly with the presence of the anxiety and depression symptoms.