Psychosomatics 41:465-471, December 2000
© 2000 The Academy of Psychosomatic Medicine
Functional Impairment in COPD Patients
The Impact of Anxiety and Depression
H. Florence Seung Kim, M.D.,
Mark E. Kunik, M.D.,
Victor A. Molinari, Ph.D.,
Stephany L. Hillman, M.Ed.,
Suleman Lalani, M.D.,
Claudia A. Orengo, M.D., Ph.D.,
Nancy J. Petersen, Ph.D.,
Ziad Nahas, M.D., and
Sheila Goodnight-White, M.D.
Received November 2, 1999; revised February 18, 2000; accepted May 5, 2000. From Baylor College of Medicine, Department of Psychiatry & Behavioral Sciences, Houston, Texas; Veterans Integrated Service Network (VISN) 16 Mental Illness Research, Education, and Clinical Center (MIRECC), Houston, Texas; Houston Veterans Affairs Medical Center, Houston Center for Quality of Care and Utilization Studies: A Veterans Affairs Health Services Research and Development Center of Excellence, Houston, Texas; Veterans Affairs Medical Center, Psychology Service, Houston, Texas; University of Houston, Department of Educational Psychology, Houston, Texas; Veterans Affairs Medical Center, Psychiatry Service, Houston, Texas; Baylor College of Medicine, Department of Medicine, Houston, Texas; Veterans Affairs Medical Center, Health Services Research & Development Field Program, Houston, Texas; Medical University of South Carolina, Institute of Psychiatry and Behavioral Sciences, Charleston, South Carolina. Address reprint requests to Dr. Mark E. Kunik, Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, One Baylor Plaza, Houston, Texas 77030–3498; e- mail mkunik{at}bcm.tmc.edu
The authors examined the relationship between functional status and comorbid anxiety and depression and the relationship between utilization of health care resources and psychopathology in elderly patients with chronic obstructive pulmonary disease (COPD). Elderly male veterans (N=43) with COPD completed anxiety, depression, and functional status measures. The authors constructed regression models to explore the contribution of COPD severity, medical burden, depression, and anxiety to the dependent variables of functional impairment and health care utilization. Anxiety and depression contributed significantly to the overall variance in functional status of COPD patients, over and above medical burden and COPD severity, as measured by the 8 scales of the Medical Outcomes Study (MOS) 36-item Short Form Health Survey. Surprisingly, medical burden and COPD severity did not contribute significantly to overall variance in functional status. Few patients were receiving any treatment for anxiety or depression.
Key Words: Depression • anxiety • COPD
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