title: Anxiety and depression are related to the outcome of emergency treatment in patients with obstructive pulmonary disease.
abstract: OBJECTIVE
  To investigate whether psychological factors predict outcome after emergency treatment for obstructive pulmonary disease.
  
  
  METHODS
  Emergency department at a university hospital.
  
  
  METHODS
  Forty-three patients presenting with exacerbation of asthma or COPD.
  
  
  METHODS
  The patients received emergency treatment and were followed up for 4 weeks.
  
  
  METHODS
  Spirometry, blood sampling, pulse oximetry, breathing rate, pulse rate, and dyspnea score was measured before and during emergency treatment. The psychological status was assessed using the hospital anxiety and depression (HAD) scale questionnaire at the end of the follow-up period.
  
  
  RESULTS
  Anxiety and/or depression was found in 17 patients (40%). Of these patients, nine patients (53%) were admitted to hospital or had a relapse within 1 month, compared with five patients (19%) in the group without anxiety and/or depression (p < 0.05). Among patients who relapsed within 1 month (n = 14), the HAD total score was 12.4 +/- 5.9 compared with 8.6 +/- 5.1 (mean +/- SD) among the patients without a relapse (p < 0.05). After making adjustments for age, gender, atopic status, treatment, and pack-years, the significant association between treatment failure and anxiety and/or depression still remained.
  
  
  CONCLUSIONS
  Our study indicates that anxiety and depression are related to the outcome of emergency treatment in patients with obstructive pulmonary disease. Further studies should be conducted evaluating the effect of treatment of anxiety and depression in patients with recurrent exacerbations of asthma and COPD.
authors.affiliation: Department of Medical Sciences, Respiratory Medicine, and Allergology, Uppsala University Hospital, Sweden. inger.dahlen@medsci.uu.se
authors.forename: Inger
authors.initials: I
authors.lastname: Dahlén
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome