Abstract

Anxiety and depression are common comorbidities in chronic obstructive pulmonary disease (COPD) patients but are often under-diagnosed. We aimed to assess the suitability of the COPD Assessment Test (CAT) in screening anxiety and depression in patients with COPD. Stable COPD patients from a cross-sectional observational study were assessed by CAT. Anxiety and depression were identified using the Generalized Anxiety Disorder questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9), respectively. Logistic regression analysis and receiver operating characteristic curve analysis were used to identify factors associated with anxiety or depression and to calculate the predictive values. A total of 530 stable COPD patients were enrolled and of those, the proportions of anxiety and depression were 17.0% and 21.5%, respectively. The adjusted odds ratios of the CAT for the presence of anxiety and depression were 1.094 (95%CI: 1.057–1.131) and 1.143 (95%CI: 1.104–1.183), respectively. The CAT score had a significant predictive value for the presence of anxiety (AUC = 0.709) and depression (AUC = 0.791) with an optimum cutoff score of 15. However, the psychometric properties of CAT were undesirable, presenting high negative predictive value (NPV) but low positive predictive value (PPV). Among CAT items, analysis further showed that non-respiratory CAT components were superior to respiratory components in identifying both anxiety and depression. Our results indicated that CAT is more useful to exclude anxiety and depression rather than detect them.

摘要

焦虑和抑郁是慢性阻塞性肺疾病 (COPD) 患者的常见合并症，但往往诊断不足。我们旨在评估 COPD 评估测试 (CAT) 在筛查 COPD 患者的焦虑和抑郁方面的适用性。通过 CAT 评估来自横断面观察研究的稳定 COPD 患者。分别使用广泛性焦虑症问卷 (GAD-7) 和患者健康问卷 (PHQ-9) 确定焦虑和抑郁。Logistic 回归分析和接受者操作特征曲线分析用于确定与焦虑或抑郁相关的因素并计算预测值。共纳入 530 名稳定期 COPD 患者，其中焦虑和抑郁的比例分别为 17.0% 和 21.5%。存在焦虑和抑郁的 CAT 调整比值比分别为 1.094 (95%CI: 1.057–1.131) 和 1.143 (95%CI: 1.104–1.183)。CAT 分数对焦虑 (AUC = 0.709) 和抑郁 (AUC = 0.791) 的存在具有显着预测价值，最佳截止分数为 15。但是，CAT 的心理测量特性并不理想，呈现出高阴性预测值 (NPV) ) 但阳性预测值 (PPV) 较低。在 CAT 项目中，分析进一步表明，非呼吸 CAT 成分在识别焦虑和抑郁方面优于呼吸成分。我们的结果表明，CAT 在排除焦虑和抑郁方面比检测它们更有用。分别。CAT 分数对焦虑 (AUC = 0.709) 和抑郁 (AUC = 0.791) 的存在具有显着预测价值，最佳截止分数为 15。但是，CAT 的心理测量特性并不理想，呈现出高阴性预测值 (NPV) ) 但阳性预测值 (PPV) 较低。在 CAT 项目中，分析进一步表明，非呼吸 CAT 成分在识别焦虑和抑郁方面优于呼吸成分。我们的结果表明，CAT 在排除焦虑和抑郁方面比检测它们更有用。分别。CAT 分数对焦虑 (AUC = 0.709) 和抑郁 (AUC = 0.791) 的存在具有显着预测价值，最佳截止分数为 15。但是，CAT 的心理测量特性并不理想，呈现出高阴性预测值 (NPV) ) 但阳性预测值 (PPV) 较低。在 CAT 项目中，分析进一步表明，非呼吸 CAT 成分在识别焦虑和抑郁方面优于呼吸成分。我们的结果表明，CAT 在排除焦虑和抑郁方面比检测它们更有用。呈现高阴性预测值（NPV）但低阳性预测值（PPV）。在 CAT 项目中，分析进一步表明，非呼吸 CAT 成分在识别焦虑和抑郁方面优于呼吸成分。我们的结果表明，CAT 在排除焦虑和抑郁方面比检测它们更有用。呈现高阴性预测值（NPV）但低阳性预测值（PPV）。在 CAT 项目中，分析进一步表明，非呼吸 CAT 成分在识别焦虑和抑郁方面优于呼吸成分。我们的结果表明，CAT 在排除焦虑和抑郁方面比检测它们更有用。