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Breathlessness, anxiety, depression and function - the BAD-F study: a cross-sectional, population prevalence study in adults.

Currow, David C; Chang, Sungwon; Reddel, Helen K; Kochovska, Slavica; Ferreira, Diana; Johnson, Miriam; Ekström, Magnus

Authors

David C Currow

Sungwon Chang

Helen K Reddel

Slavica Kochovska

Diana Ferreira

Magnus Ekström



Abstract

Introduction
Chronic breathlessness is associated with depression, but its relationship to anxiety is less clear.
Objectives
This study evaluated associations between chronic breathlessness and: anxiety; depression; functional status in the general population.
Methods
This cross sectional cohort of consenting adults (≥18 years) used an online survey. Quota sampling (n=3,000) was employed reflecting the 2016 national census for sex, age and place of residence. Other data included: Patient Health Questionnaire for Depression and Anxiety (PHQ-4); the modified Medical Research Council (mMRC) breathlessness scale and the Australia-modified Karnofsky Performance Scale (AKPS). Multinomial logistic regression assessed predictors.
Results
2977 respondents had all relevant scores; female- 51.2%; median age 45.0 (range 18-92). Prevalence of breathlessness (mMRC ≥ 2) was 2.4%; anxiety 6.0%; depression 2.7%; co-existing anxiety/depression 6.1% and poorer functional status (AKPS ≤60) 1.6%.
Poorest function was in the co-existing anxiety/depression group with 11.6%. The highest proportions of people with breathlessness were found in the co-existing anxiety/depression group (10.6%) and depression only (8.8%).
In multinomial regression, depression only and co-existing anxiety/depression were predicted by older age, longer duration of breathlessness, and poorer functional status (AKPS ≤60). The relationship between poorer functional status and co-existing anxiety/depression was striking (OR 16.1; 95% 8.3, 31.4).
Adjusted odds ratios for breathlessness and: depression only was 5.5 (95% CI 2.3,12.9); and 5.1 for co-existing anxiety/depression group (95% CI 2.7,9.7).
Conclusion
Clinically important breathlessness (mMRC ≥2) was associated with depression only and co-existing anxiety/depression. Poorer function associated with psychological morbidity in the general population requires further research.

Journal Article Type Article
Journal Journal of pain and symptom management
Print ISSN 0885-3924
Publisher Elsevier
Peer Reviewed Peer Reviewed
APA6 Citation Currow, D. C., Chang, S., Reddel, H. K., Kochovska, S., Ferreira, D., Johnson, M., & Ekström, M. (in press). Breathlessness, anxiety, depression and function - the BAD-F study: a cross-sectional, population prevalence study in adults. Journal of pain and symptom management, https://doi.org/10.1016/j.jpainsymman.2019.09.021
DOI https://doi.org/10.1016/j.jpainsymman.2019.09.021
Keywords Chronic breathlessness; Anxiety; Depression; Population survey; Prevalence study
Publisher URL https://www.sciencedirect.com/science/article/pii/S0885392419305706
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