title: The effects of anxiety and depression symptoms on treatment adherence in COPD patients.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) may cause some psychiatric disorders such as depression and anxiety, similar to other chronic diseases. Treatment adherence may be affected by worsening of cognitive functions. We aimed to show whether the symptoms of anxiety and depression affect treatment adherence by patients.
  
  
  METHODS
  Seventy-eight COPD patients were analysed at the first visit. The use of bronchodilator therapy was revised for standardization before they attended a second visit after six months. Hospital Anxiety and Depression Scale (HADS), Anxiety Sensitivity Index-3 (ASI-3) and SF-36 Questionnaire were carried out at that visit. 'National Guide of Turkish Thoracic Society for Asthma' was used for scoring method of use of the bronchodilator and evaluating treatment adherence (including maintenance therapy).
  
  
  RESULTS
  Sixty-two of 78 patients, 53 (85.5%) men and nine (14.5%) women with a mean age of 64.9 ± 9.9 joined the second visit. Thirty-three patients (53.2%) had a high-treatment adherence (HTA), whereas 29 (46.8%) had a low-treatment adherence (LTA). There were high scores of anxiety in 18 (29%) and depression in 11 (17.7%) patients. There was no statistical difference between the HTA and LTA groups in means of age, gender, educational level, presence of comorbidity, classification of COPD, high anxiety scores according to HADS and ASI-3 scores. Of the patients, 41.4% in the LTA group were still smoking, whereas it was only 12.1% in the HTA group (P = 0.009). The LTA group had higher depression scores (P = 0.004) than the HTA group. Dyspnea was found more frequent in LTA patients (P = 0.047); vitality score was also statistically low in this group (P = 0.01).
  
  
  CONCLUSIONS
  As a result, continuing smoking and the presence of depression symptoms may decrease adherence to treatment. Therefore, to increase the adherence to treatment and reduce symptoms such as dyspnea, it is important to treat any depressive symptoms that are present and to help patients cease smoking.
authors.affiliation: 1Department of Chest Diseases, Faculty of Medicine,Dokuz Eylul University,Izmir,Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Turan
authors.affiliation: 2Department of Psychiatry, Faculty of Medicine,Dokuz Eylul University,Izmir,Turkey.
authors.forename: Beyazit
authors.initials: B
authors.lastname: Yemez
authors.affiliation: 1Department of Chest Diseases, Faculty of Medicine,Dokuz Eylul University,Izmir,Turkey.
authors.forename: Oya
authors.initials: O
authors.lastname: Itil
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D004417:Dyspnea / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D018434:Sickness Impact Profile; D012907:Smoking / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D001993:Bronchodilator Agents