Features of mental status in patients for chronic obstructive lung disease with different levels of compliance

Abstract

Annotation. There is an opinion that violations of adherence to treatment in patients with chronic obstructive pulmonary disease (COPD) may be due to the presence of symptoms of depression or increased anxiety. In this regard, we assessed the frequency of symptoms of depression and increased anxiety, as well as determined their expressiveness with different levels of compliance. The severity of clinical symptoms was assessed using the Modified shortness of breath scale of the Medical Research Council, the COPD Assessment Test; adherence of patients to drug therapy was determined using the Morisky-Green questionnaire (MMAS-8); assessment of patients' mental state using the Hospital Anxiety and Depression Scale (HADS). We examined 52 patients with COPD of clinical groups B and E, GOLD 2 and 3. All patients were assessed for the level of compliance before treatment, depending on which level they were divided into subgroups: with low adherence, with an average level of adherence, with high adherence to treatment. The assessment of the reliability of differences was carried out by means of correlation analysis and according to the Mann-Whitney, Kruskal-Wallis tests, as well as using the Pearson's Chi-square (χ2) test. The analysis of indicators with a normal distribution was carried out according to the median and quartiles (Me (25; 75)). It has been established that low adherence to treatment in patients with COPD is associated with greater expressiveness of depressive symptoms, while high adherence to treatment is associated with a relatively lower degree of their expressiveness. At the same time, low adherence to treatment in patients with COPD is less associated with the presence of depressive symptoms as such. In addition, it was established that the frequency of detection of increased anxiety according to questionnaire data in the studied subgroups had significant differences. Thus, in patients with low adherence to treatment, the frequency of detection of increased anxiety was more than a third of patients, while in patients with medium and high adherence to treatment, according to the results of the questionnaire, it was detected in less than one fifth of the examined patients. Based on the above, the detection of mental disorders in patients with COPD, at least through questionnaires, followed by their further examination and treatment by a specialist can contribute to increasing their commitment to the treatment of the underlying disease.