Anxiety and depression are related to the outcome of emergency treatment in patients with obstructive pulmonary disease
Anxiety and depression are related to the outcome of emergency treatment in patients with obstructive pulmonary disease
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DOI：
10.1378/chest.122.5.1633
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发表时间：
2002-11-01
期刊：
影响因子：
9.6
通讯作者：
Janson, C
中科院分区：
文献类型：
--
作者：
Dahlén, I;Janson, C
研究目的：探讨心理因素是否可预测阻塞性肺疾病急诊治疗后的结果。
研究地点：一所大学医院的急诊科。
患者：43名哮喘或慢性阻塞性肺疾病（COPD）急性加重的患者。
干预措施：患者接受急诊治疗，并随访4周。
测量指标：在急诊治疗前和治疗期间测量肺功能（肺活量测定法）、采血、脉搏血氧饱和度、呼吸频率、脉搏频率和呼吸困难评分。在随访期结束时，使用医院焦虑抑郁（HAD）量表问卷评估心理状态。
结果：17名患者（40%）存在焦虑和/或抑郁。在这些患者中，9名患者（53%）在1个月内住院或复发，而无焦虑和/或抑郁组中有5名患者（19%）（p < 0.05）。在1个月内复发的患者（n = 14）中，HAD总分是12.4 ± 5.9，而无复发患者为8.6 ± 5.1（均数±标准差）（p < 0.05）。在对年龄、性别、特应性状态、治疗和吸烟包年数进行调整后，治疗失败与焦虑和/或抑郁之间的显著关联仍然存在。
结论：我们的研究表明，焦虑和抑郁与阻塞性肺疾病患者急诊治疗的结果相关。应进一步开展研究，评估对哮喘和COPD反复急性加重患者进行焦虑和抑郁治疗的效果。
Study objectives: To investigate whether psychological factors predict outcome after emergency treatment for obstructive pulmonary disease.Setting: Emergency department at a university hospital.Patients: Forty-three patients presenting with exacerbation of asthma or COPD.Intervention: The patients received emergency treatment and were followed up for 4 weeks.Measurement: Spirometry, blood sampling, pulse oximetry, breathing rate, pulse rate, and dyspnea score was measured before and during emergency treatment. The psychological status was assessed using the hospital anxiety and depression (HAD) scale questionnaire at the end of the follow-up period.Results: Anxiety and/or depression was found in 17 patients (40%). Of these patients, nine patients (53%) were admitted to hospital or had a relapse within 1 month, compared with five patients (19%) in the group without anxiety and/or depression (p < 0.05). Among patients who relapsed within 1 month (n = 14), the HAD total score was 12.4 +/- 5.9 compared with 8.6 +/- 5.1 (mean +/- SD) among the patients without a relapse (p < 0.05). After making adjustments for age, gender, atopic status, treatment, and pack-years, the significant association between treatment failure and anxiety and/or depression still remained.Conclusion: Our study indicates that anxiety and depression are related to the outcome of emergency treatment in patients with obstructive pulmonary disease. Further studies should be conducted evaluating the effect of treatment of anxiety and depression in patients with recurrent exacerbations of asthma and COPD.