Predictive Model for Anxiety and Depression in Spanish Patients with Stable Chronic Obstructive Pulmonary Disease.
BACKGROUND
The association between chronic obstructive pulmonary disease (COPD) and anxiety and depression is not yet completely characterized, and differences between countries may exist. We used a predictive model to assess this association in a Spanish population.


METHODS
Prospective transversal descriptive study of 204 patients with stable COPD. Concomitant anxiety or depression were diagnosed by psychiatric assessment, using the diagnostic criteria of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Sociodemographic, clinical and lung function parameters were analyzed.


RESULTS
In total, 36% of stable COPD patients had psychiatric comorbidities, but 76% were unaware of their diagnosis. Nineteen percent had a pure anxiety disorder, 9.8% had isolated depression, and 7.3% had a mixed anxiety-depression disorder. Predictive variables in the multivariate analysis were younger age, higher educational level, lack of home support, higher BODE index, and greater number of exacerbations. The ROC curve of the model had an AUC of 0.765 (P<0.001).


CONCLUSIONS
In COPD, concomitant psychiatric disorders are significantly associated with sociodemographic factors. Anxiety disorders are more common than depression. Patients with more severe COPD, according to BODE, younger patients and those with a higher educational level have a greater risk of being diagnosed with anxiety or depression in a structured psychiatric interview. In our population, most patients with psychiatric comorbidities remain unidentified.
Servicio de Neumología, Hospital de Mataró, Mataró, Barcelona, España. Electronic address: mvglezgut@hotmail.com.
María Victoria
MV
González-Gutiérrez
Servicio de Psiquiatría, Hospital Virgen de las Nieves, Granada, España.
José
J
Guerrero Velázquez
Servicio de Neumología, Hospital Virgen de las Nieves, Granada, España.
Concepción
C
Morales García
Servicio de Neumología, Hospital San Cecilio, Granada, España.
Francisco
F
Casas Maldonado
Servicio de Medicina Interna, Hospital San Cecilio, Granada, España.
Francisco Javier
FJ
Gómez Jiménez
Servicio de Neumología, Hospital Virgen de las Nieves, Granada, España.
Francisco
F
González Vargas
D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D013030:Spain / Q000453:epidemiology
Ansiedad; Anxiety; Chronic obstructive pulmonary disease; Depresión; Depression; Enfermedad pulmonar obstructiva crónica; Factores de riesgo; ICD-10; Risk factors