title: Anxiety and depression are related to dyspnea and clinical control but not with thoracoabdominal mechanics in patients with COPD.
abstract: OBJECTIVE
  To investigate the relationship between the presence of symptoms of anxiety or depression with breathing pattern and thoracoabdominal mechanics at rest and during exercise in COPD.
  
  
  METHODS
  Cross-sectional study enrolled 54 patients with COPD ranked according to Hospital Anxiety and Depression Scale (HAD) score and compared to dyspnea, clinical control, hypercapnia, breathing pattern and thoracoabdominal mechanics at rest and during exercise.
  
  
  RESULTS
  Seventeen patients with COPD had no symptoms, 12 had anxiety symptoms, 13 had depressive symptoms and 12 had both symptoms. COPD with depressive symptoms presented greater degree of dyspnea (p<0.01). Poor clinical control was observed in COPD with anxious and/or depressive symptoms (p<0.05). Breathing pattern and thoracoabdominal mechanics were similar among all groups at rest and during exercise.
  
  
  CONCLUSIONS
  COPD with symptoms of depression report more dyspnea. Anxiety and depression are associated with poor clinical control without impact on breathing pattern and thoracoabdominal mechanics in COPD.
authors.affiliation: Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Erickson
authors.initials: E
authors.lastname: Borges-Santos
authors.affiliation: Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Juliano Takashi
authors.initials: JT
authors.lastname: Wada
authors.affiliation: Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Cibele Marques
authors.initials: CM
authors.lastname: da Silva
authors.affiliation: Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Ronaldo A
authors.initials: RA
authors.lastname: Silva
authors.affiliation: Department of Pneumology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Stelmach
authors.affiliation: Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Celso R
authors.initials: CR
authors.lastname: Carvalho
authors.affiliation: Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Electronic address: adrianalunardi@usp.br.
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Lunardi
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology*; D000368:Aged; D001007:Anxiety / Q000503:physiopathology; D001696:Biomechanical Phenomena; D001784:Blood Gas Analysis; D003430:Cross-Sectional Studies; D003863:Depression / Q000503:physiopathology; D004417:Dyspnea / Q000503:physiopathology* / Q000523:psychology; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D012119:Respiration; D012132:Respiratory Muscles / Q000503:physiopathology*; D012146:Rest / Q000502:physiology; D012720:Severity of Illness Index
keywords: Anxiety; COPD; Clinical control; Depression; Dyspnea; Thoracic mechanics