title: Factors affecting the relationship between psychological status and quality of life in COPD patients.
abstract: BACKGROUND
  This study aims to (i) evaluate the association between anxiety and depressive symptoms and health-related quality of life (HRQoL); and (ii) identify the effect modifiers of this relationship in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  A total of 337 clinically stable COPD patients answered the St. George's Respiratory Questionnaire (SGRQ) (assessing HRQoL) and the Hospital Anxiety and Depression Scale (HADS). Socio-demographic information, lung function, and other clinical data were collected.
  
  
  RESULTS
  Most patients (93%) were male; they had a mean (SD) age of 68 (9) years and mild to very severe COPD (post-bronchodilator FEV1 52 (16)% predicted). Multivariate analyses showed that anxiety, depression, or both conditions were associated with poor HRQoL (for all SGRQ domains). The association between anxiety and total HRQoL score was 6.7 points higher (indicating a worse HRQoL) in current workers than in retired individuals. Estimates for patients with "both anxiety and depression" were 5.8 points lower in stage I-II than in stage III-IV COPD, and 10.2 points higher in patients with other comorbidities than in those with only COPD.
  
  
  CONCLUSIONS
  This study shows a significant association between anxiety, depression, or both conditions and impaired HRQoL. Clinically relevant factors affecting the magnitude of this association include work status, COPD severity, and the presence of comorbidities.
authors.affiliation: Servei de Pneumologia, Hospital del Mar-IMIM, Passeig Marítim 25-29, 08003 Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Balcells
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gea
authors.forename: Jaume
authors.initials: J
authors.lastname: Ferrer
authors.forename: Ignasi
authors.initials: I
authors.lastname: Serra
authors.forename: Mauricio
authors.initials: M
authors.lastname: Orozco-Levi
authors.forename: Jordi
authors.initials: J
authors.lastname: de Batlle
authors.forename: Esther
authors.initials: E
authors.lastname: Rodriguez
authors.forename: Marta
authors.initials: M
authors.lastname: Benet
authors.forename: David
authors.initials: D
authors.lastname: Donaire-González
authors.forename: Josep M
authors.initials: JM
authors.lastname: Antó
authors.forename: Judith
authors.initials: J
authors.lastname: Garcia-Aymerich
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology; D059026:Diagnostic Self Evaluation; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D011788:Quality of Life; D012044:Regression Analysis; D012179:Retirement / Q000523:psychology / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires