IMPACT OF ANXIETY AND DEPRESSION ON THE OUTCOMES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality, with acute exacerbations contributing substantially to healthcare utilization and readmissions. Psychological comorbidities particularly anxiety and depression are common in COPD and may adversely influence clinical outcomes, yet evidence regarding their impact remains inconsistent. Objective: To compare in-hospital mortality and early readmission among patients admitted with acute exacerbation of COPD (AECOPD) with and without anxiety and depression. Methods: A hospital-based descriptive study were conducted in the Department of Pulmonology, Hayatabad Medical Complex, Peshawar, from 12th -January 2025 till 15th May 2025 following ethical approval (ERC No: HMC 2345).  Patients aged 35–70 years of either gender admitted with AECOPD were enrolled using non-probability consecutive sampling. COPD were diagnosed using GOLD criteria (chronic respiratory symptoms with post-bronchodilator FEV1/FVC <70%). Anxiety and depression were assessed via the Hospital Anxiety and Depression Scale (HADS), with cut-offs of ≥11 on respective subscales. Standard AECOPD management were provided to all participants. Primary outcomes were in-hospital mortality and early readmission (≤15 days post-discharge). Data were analyzed in IBM SPSS v25 using descriptive statistics and Chi-square/Fisher’s exact tests at a significance level of p ≤0.05, with stratification to control for effect modifiers. Results (Expected/Preliminary Summary): Higher proportions of early readmission and adverse outcomes are anticipated among patients with anxiety and/or depression, particularly in those with advanced GOLD stages and active smoking status, suggesting a clinically meaningful association between psychological comorbidity and COPD prognosis. Conclusion: Anxiety and depression are expected to be significant correlates of poorer short-term outcomes in AECOPD. Routine psychological screening and integrated management strategies may improve patient care, reduce readmissions, and inform comprehensive COPD management policies.