Meshing Anxiety, Depression, Quality of Life, and Functionality in Chronic Disease

Anxiety and depression result in a greater health burden; both can impact functionality and quality of life. This review aims to understand the association between anxiety, depression, functionality, and quality of life. Although three systematic reviews exist, one focuses on quality of life in depression and anxiety, while the others address functionality in depression and anxiety, with the former being more recent and the latter two being older. The association between these four variables will be explored.

A literature search of MEDLINE with Full Text, CINHAL PLUS with Full Text, Psychology and Behavioral Sciences Collection, and Academic Search Complete was conducted from 1 January 2017 to 22 November 2022. Seven studies involving 2279 adults were included.

All studies analyzed the association between anxiety and/or depression with functionality and/or quality of life, in a population with a primary chronic condition. We found the higher functionality (return to work, no sedentary lifestyle, and no fatigue) and quality of life are, the lower the values of anxiety and depression will be. The HADS is a consensual instrument to access anxiety and depression, but the same cannot be said for assessing functionality and quality of life.

The severity of the chronic disease and the loss of functionality and quality of life seem to increase psychological distress. This study highlights the importance of a multidisciplinary and holistic approach, focusing not only on clinical outcomes but also on overall well-being. Further longitudinal research is needed to support the association between these variables to draw more concrete conclusions with scientific evidence.