title: Association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  This was a single-centre, cross-sectional, observational study performed at a tertiary care hospital in India to study the association of psychiatric co-morbidities and quality of life with severity of chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  A total of 59 clinically stable patients with COPD were assessed for disease severity, as per the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline (2013). Psychiatric co-morbidities like anxiety disorders and depression were diagnosed by clinician-administered interview (as per the DSM-V criteria). Insomnia, anxiety disorders and depression, as well as quality of life were also assessed by self-rating scales including Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and St. George's Respiratory Questionnaire, respectively.
  
  
  RESULTS
  Depression was the commonest psychiatric co-morbidity affecting 32.2% of individuals. Patients with depression and anxiety disorders had higher score in COPD assessment test (p = 0.02 and p = 0.004, respectively), ISI (p < 0.001 and p = 0.01, respectively), and poorer quality of life (p < 0.001 and p = 0.02, respectively) compared with those without these conditions. Patients with severe symptoms of COPD were more likely to suffer from anxiety (p = 0.001), depression (p = 0.01), insomnia (p = 0.01), and have poor quality of life (p < 0.001). Patients in the GOLD-D (i.e. those at high risk and with more symptoms) group had poorer quality of life (p = 0.004) when compared with GOLD-A (low risk and less symptoms) and GOLD-C (high risk and less symptoms) groups.
  
  
  CONCLUSIONS
  Patients with psychiatric co-morbidities have severe symptoms of COPD and poor quality of life.
authors.affiliation: Department of Pulmonary Medicine, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.
authors.forename: J R
authors.initials: JR
authors.lastname: Mehta
authors.affiliation: Department of Psychiatry, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.
authors.forename: I J
authors.initials: IJ
authors.lastname: Ratnani
authors.affiliation: Department of Pulmonary Medicine, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.
authors.forename: J D
authors.initials: JD
authors.lastname: Dave
authors.affiliation: Department of Psychiatry, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.
authors.forename: B N
authors.initials: BN
authors.lastname: Panchal
authors.affiliation: Department of Pulmonary Medicine, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Patel
authors.affiliation: Department of Psychiatry, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, Gujarat, India.
authors.forename: A U
authors.initials: AU
authors.lastname: Vala
mesh_terms: D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D018570:Risk Assessment; D012720:Severity of Illness Index
keywords: Anxiety; Depression; Mental disorders; Pulmonary disease, chronic obstructive; Quality of life