Jul 2026· Journal of Health and Rehabilitation Research· 0 citations· 26 references
TL;DR
Pakistan patients with COPD experienced marked symptom burden and HRQoL impairment, supporting multidimensional assessment beyond spirometry alone, and CAT, FEV₁, and probable depression remained independently associated with HRQoL.
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is associated with airflow limitation, substantial symptom burden, functional restriction, psychological morbidity, and impaired health-related quality of life (HRQoL). Patient-reported measures may capture disease burden not fully reflected by spirometric severity. Objective: To assess HRQoL and symptom burden among patients with COPD in Pakistan and examine their relationships with airflow limitation, respiratory symptoms, and psychological characteristics. Methods: This cross-sectional study included 93 patients with COPD attending Johar Institute of Professional Studies from March to September 2025. Clinical variables included demographics, smoking and biomass exposure, COPD duration, FEV₁ percentage predicted, and GOLD stage. Symptom burden was assessed using the COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) scale, while HRQoL was evaluated using the St George’s Respiratory Questionnaire (SGRQ) and estimated EQ-5D index. Depression and anxiety were classified using PHQ-9- and GAD-7-based criteria. Data were analysed using SPSS version 26.0. Results: Mean age was 60.43±8.69 years; 69.9% were male. GOLD 2 disease was present in 68.8%, while 21.5% had GOLD 3–4 disease. Mean CAT and SGRQ scores were 25.19±9.97 and 59.41±15.34, respectively; 79.6% had CAT >10 and 80.6% had mMRC ≥2. CAT correlated strongly with SGRQ (ρ=0.869) and inversely with EQ-5D (ρ=−0.846), while FEV₁ showed weaker correlations. CAT, FEV₁, and probable depression remained independently associated with HRQoL. Conclusion: Pakistani patients with COPD experienced marked symptom burden and HRQoL impairment, supporting multidimensional assessment beyond spirometry alone. Keywords: COPD; quality of life; CAT; SGRQ; dyspnea; EQ-5D; Pakistan.
A « High Functional Disability » (HFD) phenotype defined by HAQ-DI ≥ 1 (n = 20), and characterized by COPD poor prognosis markers and severe disease burden is identified, which could benefit from personalised management such as pulmonary rehabilitation and psychological support.
Joffroy Rogier, A. Vivien, Loïs Bolko et al.· International Journal of COP...· 0 citations
Integrating clinical severity with health-related quality of life, psychosocial, and functional measures is essential to fully capture the impact of the disease and to inform patient-centred treatment strategies in patients with bronchiectasis. Accordingly, this study aimed to investigate the determinants of health-related quality of life in non-cystic fibrosis bronchiectasis, examining how psychological factors, disease severity, and functional exercise capacity interact in patients' self-reported quality of life. This prospective observational study included patients with non-cystic bronchiectasis (NCFB) aged 18-60 years. Disease severity was classified using Bronchiectasis Severity Index (BSI). Assessments included the Hospital Anxiety and Depression Scale (HADS), Medical Outcomes, Short-Form Health Survey (SF-36), Leicester Cough Questionnaire (LCQ), Quality of Life in Bronchiectasis (QOL-B), and Six-Minute Walk Test (6MWT). Pearson correlations and multiple linear regression were used to examine associations between psychological variables and outcomes. Thirty-one patients participated (54.8% female; mean age 52.45 ± 15.3 years), and 83.9% had mild - moderate disease. HRQoL was related to anxiety, depression, and functional exercise capacity, and anxiety was also associated with cough severity. Anxiety was negatively associated with the SF-36 Mental health domain (β = -1.80; p = 0.03) and the QOL-B Emotional functioning domain (β = -2.79; p = 0.01), while depression was associated with SF-36 Mental health (β = -2.26; p = 0.01). No association was found between prognostic severity of the disease and HRQoL. Psychological factors and exercise capacity were the main determinants of HRQoL in patients with mild to moderate NCFB, highlighting the importance of simple functional markers, such as the six-minute walk test (6MWT) and mental health assessment, in clinical evaluation and treatment planning.
Beatriz Andresa da Silva Galli, Daniel Oliveira dos Santos, J. Perossi et al.· Psychology, Health & Medicin...· 0 citations
It was found that age, gender, level of education, occupation, smoking status, feeling restless, and loss of interest in work were significantly associated with the quality of life among participants.
Increased depressive symptoms were associated with a higher risk of pre-COPD phenotypes, respiratory symptoms, and mortality, and may be a treatable trait that can help mitigate adverse outcomes in participants with pre-COPD.
Background: Chronic obstructive pulmonary disease (COPD) is frequently accompanied by psychological distress, but the relationship between GOLD stage, dyspnea, functional limitation, and depression/anxiety symptoms remains incompletely defined. This study examined clinical and psychological profiles across GOLD stages, with particular attention to GOLD stages 3 and 4. Methods: This multicenter observational study included 285 adults with spirometry-confirmed COPD evaluated in Romania between 2023 and 2026. COPD severity was classified according to GOLD stages. Clinical assessment included FEV1, peripheral oxygen saturation, smoking exposure, the COPD Assessment Test (CAT), and the modified Medical Research Council dyspnea scale (mMRC). Psychological and well-being measures included DASS depression, anxiety, and stress scores; WHO-5; major depressive disorder score, and generalized anxiety disorder score. Descriptive analyses were performed across GOLD stages, and GOLD 3 was directly compared with GOLD 4. Results: GOLD 3 was the largest subgroup (n = 106, 37.2%), followed by GOLD 4 (n = 81, 28.4%), GOLD 2 (n = 69, 24.2%), and GOLD 1 (n = 29, 10.2%). GOLD 3 patients showed marked dyspnea and symptom burden, with mean mMRC = 2.92 and CAT = 24.44. DASS depression, anxiety, and stress scores were higher in GOLD 3 than GOLD 2, but did not increase further in GOLD 4. Direct GOLD 3 versus GOLD 4 comparisons showed no significant differences in DASS depression or DASS anxiety, whereas GOLD 4 had a significantly higher mMRC, major depressive disorder score, and generalized anxiety disorder score. Conclusions: GOLD 3 COPD was associated with substantial dyspnea, functional limitation, and measurable psychological distress. However, depression and anxiety patterns varied by instrument, suggesting that psychological burden in COPD is multidimensional and not explained by spirometric severity alone.
Background: COPD has been associated with decreased QOL as well as various psychological disorders like anxiety, depression and stress. The study conducted was to measure psychological distress among COPD patients and the relation of it with QOL.
Methods: A cross-sectional study done on 74 COPD patients who had their consultation in a tertiary care hospital at Jaipur, Rajasthan, India. The QOL among COPD patients was evaluated applying CAT. Depression, anxiety and stress levels were assessed using the DASS-21 questionnaire. The relationship between QOL and psychological distress parameters was assessed using Spearman’s correlation test, Kruskal–Wallis test and multiple linear regression analysis.
Results: The mean CAT score was 29.19±9.53 which implied poor QOL among COPD patients. Moderate depression was found in 40.5% of COPD patients while extremely severe anxiety was found in 77% of the patients. Poor QOL showed significant correlation with depression (ρ=0.394, p<0.001), anxiety (ρ=0.548, p<0.001) and stress (ρ=0.443, p <0.001). Increased disease duration was strongly correlated with elevated psychological distress scores. In multiple regression analysis, anxiety was found to be the only independent predictor of poor QOL (B=0.618, p<0.001).
Conclusions: There is significant impairment in the QOL as well as a heavy psychological burden in terms of anxiety among COPD patients. Psychometric evaluation should be included as a key aspect of COPD management.
Pushpendra Kumar, A. Husain, Rishabh Gupta et al.· International Journal of Bas...· 0 citations
