Journal
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Volume 9, Issue -, Pages 501-512Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/COPD.S58136
Keywords
long-term conditions; COPD; quality of life; panic
Categories
Funding
- National Institute for Health Research [RP-PG-0707-10162]
- University of Manchester
- National Institute for Health Research and Care (CLAHRC) for the South West Peninsula
- National Institute for Health Research (NIHR) [RP-PG-0707-10162]
- Medical Research Council [MR/K006665/1, MC_PC_13042] Funding Source: researchfish
- National Institute for Health Research [RP-PG-0707-10162] Funding Source: researchfish
- MRC [MR/K006665/1] Funding Source: UKRI
- National Institutes of Health Research (NIHR) [RP-PG-0707-10162] Funding Source: National Institutes of Health Research (NIHR)
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Background: The causal association between depression, anxiety, and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD) is unclear. We therefore conducted a systematic review of prospective cohort studies that measured depression, anxiety, and HRQoL in COPD. Methods: Electronic databases (Medline, Embase, Cumulative Index to Nursing and Allied Health Literature [CINAHL], British Nursing Index and Archive, PsycINFO and Cochrane database) were searched from inception to June 18, 2013. Studies were eligible for inclusion if they: used a nonexperimental prospective cohort design; included patients with a diagnosis of COPD confirmed by spirometry; and used validated measures of depression, anxiety, and HRQoL. Data were extracted and pooled using random effects models. Results: Six studies were included in the systematic review; of these, three were included in the meta-analysis for depression and two were included for the meta-analysis for anxiety. Depression was significantly correlated with HRQoL at 1-year follow-up (pooled r=0.48, 95% confidence interval 0.37-0.57, P<0.001). Anxiety was also significantly correlated with HRQoL at 1-year follow-up (pooled r=0.36, 95% confidence interval 0.23-0.48, P<0.001). Conclusion: Anxiety and depression predict HRQoL in COPD. However, this longitudinal analysis does not show cause and effect relationships between depression and anxiety and future HRQoL. Future studies should identify psychological predictors of poor HRQoL in well designed prospective cohorts with a view to isolating the mediating role played by anxiety disorder and depression.
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