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

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


Irina Kinchin

David C. Currow

Sungwon Chang

Helen K Reddel

Slavica Kochovska

Diana Ferreira

Magnus Ekström


© 2019 American Academy of Hospice and Palliative Medicine Context: Breathlessness is associated with depression, but its relationship to anxiety or impaired function is less clear. Objectives: This study evaluated associations between chronic breathlessness and anxiety, depression, and functional status in the general population. Methods: This cross-sectional study of consenting adults (18 years and older) used an online survey. Quota sampling (n = 3000) was used reflecting the 2016 national census for sex, age, and place of residence. Other data included Four-Item Patient Health Questionnaire for depression and anxiety, the modified Medical Research Council (mMRC) Breathlessness Scale, and the Australia-modified Karnofsky Performance Scale. Multinomial logistic regression assessed predictors. Results: About 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%, coexisting anxiety/depression 6.1%, and poorer functional status (Australia-modified Karnofsky Performance Scale ≤60) 1.6%. In multinomial regression, depression, anxiety, and coexisting anxiety/depression were predicted by younger age, longer duration of breathlessness, and poorer functional status. The highest proportions of people with breathlessness were found in the coexisting anxiety/depression group (10.6%) and depression only group (8.8%). Poorest function was in the coexisting anxiety/depression group with 11.6%. The relationship between poorer functional status and coexisting anxiety/depression was significant (odds ratio 0.90; 95% CI 0.89, 0.92). Adjusted odds ratio for breathlessness and depression only was 3.0 (95% CI 1.2, 7.8). Conclusion: Clinically important breathlessness (mMRC ≥2) was associated with depression, anxiety, and coexisting anxiety/depression. Poorer function that is associated with psychological morbidity in the general population requires further research.


Reddel, H. K., Kinchin, I., Currow, D. C., Chang, S., Reddel, H. K., Kochovska, S., …Ekström, M. (2020). Breathlessness, anxiety, depression and function - the BAD-F study: a cross-sectional, population prevalence study in adults. Journal of pain and symptom management, 59(2), 197-205.e2.

Journal Article Type Article
Acceptance Date Sep 21, 2019
Online Publication Date Oct 22, 2019
Publication Date Feb 1, 2020
Deposit Date Dec 20, 2019
Publicly Available Date Oct 23, 2020
Journal Journal of Pain and Symptom Management
Print ISSN 0885-3924
Electronic ISSN 1873-6513
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 59
Issue 2
Pages 197-205.e2
Keywords Chronic breathlessness; Anxiety; Depression; Population survey; Prevalence study
Public URL
Publisher URL


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