Aug 2026· Medicina· Vol 62, pp. 1500· 0 citations· 28 references
Medicine
TL;DR
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.
Abstract
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.
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.
Zarish Younas, Ashar Yousaf, Adden Anis Khan et al.· Journal of Health and Rehabi...· 0 citations
This study aimed to examine the relationship between dyspnea-related fear of movement and clinical variables in patients with Chronic Obstructive Pulmonary Disease (COPD). The cross-sectional study included 59 patients with COPD. Perception of dyspnea (Modified Medical Research Council Dyspnea Scale (mMRC)), functional exercise capacity (6-min walk test (6MWT)), respiratory function (spirometry), maximal inspiratory and expiratory pressures (MIP/MEP- mouth pressure measurement device), quadriceps (QS) muscle strength (digital dynamometer), balance (Mini-Balance Evaluation Systems Test (Mini-BESTest)), and dyspnea-related fear of movement (Breathlessness Beliefs Questionnaire (BBQ)) were assessed. The perception of fear of movement associated with dyspnea was found to be related to mMRC, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, spirometry, digital dynamometer, 6MWT and Mini-BESTest (r = .318- .488, p < .05), but not to MIP, MEP and other clinical variables (p > .05). Regression analysis showed that fear of movement due to dyspnea explained 9% of the variance in QS muscle strength, 15% in 6MWT distance, and 9% in Mini-BESTest score. Fear of movement due to dyspnea was identified as a clinically relevant factor in COPD patients, with BBQ scores notably higher than those reported in previous studies, and affected QS muscle strength, balance, and functional exercise capacity.
Çağla Nur Yetim, Saniye Aydoğan Arslan, Selma Demir· Evaluation & the Health Prof...· 0 citations
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting problem with the lungs that leads to many symptoms, poor quality of life, and greater use of the health care system. The aim of this study was to evaluate longitudinal changes in symptom distress among patients with chronic obstructive pulmonary disease (COPD) over a 6- months follow-up period and to examine the association between baseline symptom distress and disease severity. In total, 341 patients with COPD were recruited from the Department of Pulmonology at Maharishi Markandeshwar (Deemed to be University) Hospital in Mullana, Haryana, India. The Symptom Distress Scale (SDS) was used to calculate symptom distress at baseline, 3 months, and 6 months post-enrolment into the study. Demographics (age and sex) and clinical data (exacerbation history, number of medications take, etc.) were collected using a standardized data collection sheet and statistical analyses were done using SPSS version 25.0. Most of the patients were in GOLD Stage II (58.7%) or GOLD Stage III (28.4%). The mean SDS scores decreased substantially from a baseline score of 26.38 ± 8.18 to a score of 24.59 ± 8.18 at 3 months and a score of 21.65 ± 9.39 at 6 months (p < 0.001). There were strong correlations between baseline SDS scores and the SDS scores at 3 months (r = 0.951, p < 0.001) and at 6 months (r = 0.812, p < 0.001). Baseline SDS scores did not differ significantly between the COPD severity stages (p = 0.271). Multiple regression analysis revealed that age, gender, smoking status, COPD duration, and disease severity were not significant predictors of baseline symptom distress. A significant reduction in mean symptom distress scores was observed among patients with COPD over the 6-months follow-up period; however, the observation design does not allow conclusions regarding the factors responsible for these changes.
Omveer Singh, Adarsh, M. Mishra et al.· Respiratory Medicine· 0 citations
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
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.
