Abstract
Background
Panic is a common comorbidity in COPD but little is known about its impact on health-related quality of life (HRQoL). HRQoL is an important outcome in COPD as it drives healthcare use, physical functioning and mortality. We aimed to test whether panic predicted HRQoL in COPD.
Method
Longitudinal cohort study of COPD patients recruited from 10 General Practices in Manchester, UK, with 12 month follow-up. Predictors were panic (PDSR), depression and anxiety (HADS), severity (FEV1), threatening life events (LTE-Q) and healthcare use. The primary outcome was HRQoL (CRQ). Regression and structural equation modelling (SEM) were used to model predictive relationships.
Results
414 patients recruited at baseline; 270 (65%) returned a complete questionnaire. 232 eligible for 12 month follow-up; 188 (81%) completed a questionnaire. Mean age 69 years (sd 11) and 50.7% were male; participants had 2 or more comorbid health problems and mean FEV1 % predicted of 58.2 (sd 18). 43% were depressed, 46% anxious and 14% met the criteria for panic disorder. In simple linear regression panic was a significant predictor of HRQoL; this relationship was not significant in multiple regression analyses. SEM analysis showed that anxiety predicts depression which in turn predicts HRQoL at 12 months but panic does not.
Discussion
Panic is associated with HRQoL in COPD but it does not predict it over the long-term when analysed with depression and anxiety. We should therefore focus on identifying and treating anxiety and depression. However, this finding is based on a small study and therefore the role of panic in COPD should be evaluated further in larger samples.
- © 2014 ERS