Page 59 - Livre électronique des RFTP 2025

P17. PSYCHOLOGICAL DISTRESS IN COPD PATIENTS:

LINKS TO DISEASE SEVERITY AND EXACERBATIONS

M.RHIMI¹, I.TOUIL¹, F.E.DABBEBI¹, A.BARKA¹, N.MANSOUR¹, S.BENABDALLAH²

¹ PNEUMOLOGY DEPARTMENT, REGIONAL HOSPITAL OF MOKNINE
² INTENSIVE UNIT CARE DEPARTMENT, REIONAL HOSPITAL OF MOKNINE

Background : Chronic obstructive pulmonary disease (COPD) patients frequently
experience psychological comorbidities that significantly impact disease
management and quality of life. The assessment of anxiety and depression
symptoms remains inconsistently implemented in clinical practice. The relationship
between those psychological distress and COPD severity markers requires further
characterization in real-world populations. This study aimed to determine the
prevalence of clinically significant anxiety and depression symptoms using the HAD
scale and their associations with pulmonary function, exacerbation history, and
disease staging in a clinical COPD cohort.

Methods : We conducted a prospective study in the Pneumology Department of
Moknine regional hospital during the year of 2024, including COPD patients.
Comprehensive assessments included: administration of the HAD scale to measure
anxiety (HAD-A) and depression (HAD-D) symptoms; post-bronchodilator
spirometry with FEV1 measurement; GOLD stage classification and detailed
exacerbation history documentation.

Results : Forty five patients were included, with a mean age of 67.3±10.1 years and
82.2% male. The mean HAD-A and HAD-D scores were 8.44±3.89 and 8.24±4.28
respectively. The analysis revealed that 55.5% of patients (25/45) scoring above the
clinical cutoff for anxiety and 44.4% (20/45) for depression. Over one-third of patients
(38%) exhibited both comorbid anxiety and depression symptoms. Strong
correlations emerged between higher HAD scores and advancing GOLD stage
(r=0.32, p=0.02), frequent exacerbations (≥2/year; r=0.38, p=0.01), and lower FEV1%
predicted (r=-0.29, p=0.03). Regression modeling identified three independent
predictors accounting for 38% of variance in total HAD scores: GOLD stage (β=0.34,
p=0.01), annual exacerbation rate (β=0.28, p=0.03), and nocturnal hypoxemia
duration (β=0.22, p=0.04).

Conclusion : This study demonstrates high prevalence of clinically significant
anxiety and depression symptoms among COPD patients, strongly associated with
conventional markers of disease severity. Those findings support integrated care
models that combine pulmonary rehabilitation with psychological support,
particularly for patients with advanced disease (GOLD 3-4) or frequent acute
exacerbations.

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