Anxiety and depression among patients at a tertiary care respiratory clinic in Sri Lanka

Abstract

BACKGROUND: Chronic respiratory diseases are associated with increased risk of mood and anxiety disorders. These disorders in turn may lead to frequent hospital admissions and lower treatment adherence among patients with respiratory disease. AIMS: The objective of this study was to describe the prevalence of anxiety and depression among patients with chronic lung diseases and their association with socio demographic factors. Methods: A descriptive cross sectional study was conducted among patients at a respiratory outpatient clinic at the National Hospital for Respiratory Diseases, Welisara. Demographic data was collected using an interviewer administered questionnaire; a selfadministered Hospital Anxiety and Depression scale was used to examine for the presence of anxiety or depression. Consecutive patients who gave written informed consent to were included in the study. RESULTS: A total of 451 patients were participated in the study, of whom 274 (60.8%) were females. The mean age was 57.4 (SD=15.3) years and the majority (74.7%) were married. The education level of 226 (50.1%) was between grade 5 and grade 11. There was no permanent income for 196 (43.5%). The majority had bronchial asthma (60.3%) and 151 (33.5%) had one or more co-morbid medical illness. The mean score for the anxiety component was 6.78 (SD=3.59) and for the depression component it was 7.03 (SD=3.11). Seventy (15.5%) screened positive for anxiety and another 100 (22.2%) were doubtful cases. Sixty five (14.4%) screened positive for depression and another 128 (28.4%) were doubtful cases. Participants who were unmarried, divorced, separated or widowed had significantly higher levels of anxiety compared to those who were married (p=0.005). Patients who had a monthly income also had more anxiety compared to those who did not have an income (p=0.003). Conclusions: One fifth of the patients attending the respiratory clinic screened positive for anxiety and depression. This indicates the importance of addressing the psychological morbidity among patients with chronic lung disease.