title: Overview of the Impact of Depression and Anxiety in Chronic Obstructive Pulmonary Disease.
abstract: Anxiety and depression are common entities in patients diagnosed with COPD. However, the impact that they have on the exacerbation of illness is scarcely studied.
  
  
  
  To determine if the presence of anxiety and depression is associated with a greater risk of frequent exacerbation (≥2 per year) in patients diagnosed with COPD.
  
  
  
  A cohort study that analysed frequent exacerbation and associated factors in 512 patients monitored during 2 years. Exacerbations were defined as events that required antibiotic/s and/or systemic corticosteroids (moderate) or hospitalization (serious). Variables of interest were recorded for each patient, including anxiety and depression (Hospital Anxiety and Depression Scale), and we analysed their association with frequent exacerbation through the adjusted odds ratio (aOR) by means of a logistic regression model.
  
  
  
  The prevalence of anxiety/depression at the start of the study was of 15.6%. During the 2 years of monitoring, 77.9% of the patients suffered at least moderate-to-severe exacerbation. 54.1% were frequent exacerbators. Anxiety/depression were strongly associated with moderate-severe frequent exacerbation in the crude analysis (ORc= 2.28). In the multivariate analysis, the risk factors also associated with frequent exacerbation were being overweight (aOR 2.78); obesity (aOR 3.02); diabetes (aOR 2.56) and the associated comorbidity (BODEx) (ORa = 1.45).
  
  
  
  The prevalence of anxiety/depression in COPD patients is high, and they are relevant risk factors in frequent exacerbation although the effect is lower in the multivariate analysis when adjusting for different variables strongly associated with exacerbation.
authors.affiliation: Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain. jmontser@alumni.unav.es.|Health Department, Public Health Agency of Catalonia, Avda Rovira Roure, 2, 25006, Lleida, Catalonia, Spain. jmontser@alumni.unav.es.|Catalan Institute of Health (ICS), Consultori local de Bellvís (ABS Pla d'Urgell), c/ Major, 19, 25142, Bellvís, Catalonia, Spain. jmontser@alumni.unav.es.
authors.forename: Josep
authors.initials: J
authors.lastname: Montserrat-Capdevila
authors.affiliation: Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain.|Health Department, Public Health Agency of Catalonia, Avda Rovira Roure, 2, 25006, Lleida, Catalonia, Spain.|Faculty of Medicine, University of Lleida, c/ de Montserrat Roig, 2, 25008, Lleida, Catalonia, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Godoy
authors.affiliation: Primary Care Research Institute (IDIAP) Jordi Gol, Universitat Autònoma of Barcelona, Avda de Rambla Ferran, 44, 25007, Lleida, Catalonia, Spain.|Epidemiology Unit, Cardiovascular Department, University Hospital Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Catalonia, Spain.
authors.forename: Josep Ramon
authors.initials: JR
authors.lastname: Marsal
authors.affiliation: Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain.|University Hospital Arnau de Vilanova, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain.|Respiratory Diseases Group, Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain.|Biomedical Research Centre/Respiratory Diseases Network (CIBERES), Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
authors.affiliation: Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain.|Faculty of Medicine, University of Lleida, c/ de Montserrat Roig, 2, 25008, Lleida, Catalonia, Spain.|Psychiatry Department, University Hospital Santa Maria, Avda Rovira Roure, 44, 25198, Lleida, Catalonia, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Pifarré
authors.affiliation: Biomedical Research Institute (IRB) of Lleida, Avda Rovira Roure, 80, 25198, Lleida, Catalonia, Spain.|Health Department, Public Health Agency of Catalonia, Avda Rovira Roure, 2, 25006, Lleida, Catalonia, Spain.|Faculty of Medicine, University of Lleida, c/ de Montserrat Roig, 2, 25008, Lleida, Catalonia, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Alsedà
authors.affiliation: Primary Care Research Institute (IDIAP) Jordi Gol, Catalan Institute of Health (ICS), Avda de Rambla Ferran, 44, 25007, Lleida, Catalonia, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Ortega
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D000067251:Symptom Flare Up
keywords: Anxiety; Chronic obstructive pulmonary disease (COPD); Depression; Exacerbation