Work

Anxiety and Depressive Symptoms Among Patients with Chronic Obstructive Pulmonary Disease Attending a Tertiary Pulmonary Clinic in Damascus, Syria: A Cross-Sectional Study of Spirometric and Patient-Reported Correlates

Year: 2026

Type: article

Abstract: Background: Anxiety and depressive symptoms are common but often underrecognized in chronic obstructive pulmonary disease (COPD), while evidence from resource-limited settings remains scarce. This study assessed their prevalence and correlates among patients with COPD attending a tertiary pulmonary clinic in Damascus, Syria. Methods: This cross-sectional, single-center convenience-sample study included 249 patients with COPD at Al-Mouwassat Hospital. Anxiety and depressive symptoms were assessed using validated Arabic versions of the GAD-7 and PHQ-9. Clinically relevant symptoms were defined as GAD-7 ≥10 and PHQ-9 ≥10. Spirometric impairment was characterized using FEV1% predicted. The GAD-specific challenge burden score ranged from 0 to 4 and was modeled as a continuous predictor. Bivariate analyses were followed by multinomial logistic regression for GAD-7 severity and proportional-odds ordinal logistic regression for PHQ-9 severity, with sensitivity analyses using GOLD-based FEV1 categories and binary symptom thresholds. Results: Clinically relevant anxiety and depressive symptoms were present in 30.9% and 73.9% of participants, respectively. Each one-point increase in the GAD-specific challenge burden score was associated with mild anxiety (adjusted OR, 7.07; 95% CI, 3.36-14.89) and moderate-to-severe anxiety (adjusted OR, 26.95; 95% CI, 10.32-70.41). Older age and lower FEV1% predicted were additionally associated with moderate-to-severe anxiety. Greater depressive symptom severity was associated with lower FEV1% predicted, COPD duration ≥1 year, and difficulty performing daily tasks. Sensitivity analyses showed consistent findings. Conclusion: Anxiety and depressive symptoms were common in this outpatient cohort. Both spirometric impairment and patient-reported symptom and functional burden were associated with psychological symptom severity, supporting multidimensional COPD assessment.

Source: International Journal of COPD

DOI: 10.2147/copd.s637954

Authors: Ibrahim Alkhatib, Mohammad Alaa Aldakak, Othman Alawad Almlhem, Lama Alsaoub, Hussam Al-Bardan

Institutions: Syrian Private University, Damascus University

Language: English

Topic: Chronic Obstructive Pulmonary Disease (COPD) Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836