Psychological Distress in COPD Assessed by DASS-21-R: Multivariable Regression and Bayesian Analysis Across GOLD...

Area of Science:

• Pulmonary Medicine
• Psychiatry
• Clinical Psychology

Background:

• Psychological distress, including depression, anxiety, and stress, is a frequent comorbidity in patients with chronic obstructive pulmonary disease (COPD).
• The precise relationship between the severity of COPD and psychological distress remains insufficiently understood.
• This study investigated the prevalence and distribution of depression, anxiety, and stress across different COPD severity stages.

Purpose of the Study:

• To assess depression, anxiety, and stress levels in clinically stable COPD patients using the Depression Anxiety Stress Scales-21 (DASS-21).
• To examine the association between COPD severity, classified by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, and psychological distress.
• To identify predictors of COPD severity and psychological distress in this patient population.

Main Methods:

• A multicenter, cross-sectional observational study involving 285 clinically stable COPD patients.
• COPD severity was categorized using GOLD criteria.
• Statistical analyses included multinomial and binary logistic regression, Bayesian independent sample analyses, and ANOVA effect size estimates to identify predictors and assess differences.

Main Results:

• Smoking exposure and dyspnea severity were independently associated with advanced COPD stages.
• COPD severity (airflow limitation) was not independently associated with clinically significant depression, anxiety, or stress.
• Higher symptom burden, measured by the COPD Assessment Test (CAT) score, was consistently associated with increased depression, anxiety, and stress.

Conclusions:

• Psychological distress is prevalent across all stages of COPD severity and is not solely determined by airflow limitation.
• Symptom burden, rather than spirometric severity, appears to be more closely linked to emotional well-being in COPD patients.
• These findings suggest a need to address symptom management for improving psychological outcomes in COPD care.