title: Anxiety and depression in COPD patients and correlation with sputum and BAL cytology.
abstract: OBJECTIVE
  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 psychological aspects of COPD, to test the BODE index (a composite score of body mass, obstruction, dyspnea and exercise capacity), and to evaluate the association between atypical cytologic 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 performed 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.
authors.affiliation: Pulmonary Diseases Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. docmct@superonline.com.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Tetikkurt
authors.forename: Imran
authors.initials: I
authors.lastname: Ozdemir
authors.forename: Seza
authors.initials: S
authors.lastname: Tetikkurt
authors.forename: Nail
authors.initials: N
authors.lastname: Yılmaz
authors.forename: Turan
authors.initials: T
authors.lastname: Ertan
authors.forename: Nihal
authors.initials: N
authors.lastname: Bayar