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Lookup NU author(s): Professor Anthony De SoyzaORCiD, Georgina Wild, Phil Mawson, Dr John Steer, Dr Richard McNallyORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
©The authors 2025. Background: Bronchiectasis is associated with psychological comorbidity and poor quality of life (QoL), yet guidelines lack focus on psychological morbidity. Using data obtained from the BronchUK database (1341 patients), we examined the link between anxiety/depression and physical disease severity, QoL and long-term outcomes in bronchiectasis. Methods: Computed tomography-confirmed bronchiectasis patients enrolled in the BronchUK study with Hospital Anxiety and Depression Scale (HADS-A/D) data were studied. HADS-A/D scores ⩾8 indicated anxiety/depression. QoL was measured by the St George’s Respiratory Questionnaire and QoL-Bronchiectasis Questionnaire. Exacerbations during annual follow-up were analysed by negative binomial regression with time in study as an offset adjusted for age, body mass index, sex, Pseudomonas infection, diabetes and forced expiratory volume in 1 s (FEV1). Cox regression determined probability of hospitalisation using time to first exacerbation. Results 1341 patients were included; 418 had anxiety (31%), 269 (20%) had depression and 201 (15%) had both conditions. HADS-A/D ⩾8 was associated with worse QoL (p<0.0001) and clinical severity (e.g. Bronchiectasis Severity Index, FEV1 and Medical Research Council dyspnoea score (all p<0.01). HADS-A/D ⩾8 each was associated with exacerbation (rate ratio (RR) 1.42, 95% CI 1.32–1.52 for HADS-A; RR 1.45, 95% CI 1.34–1.56 for HADS-D, both p<0.0001) and hospitalisation risk (RR 1.58, 95% CI 1.29– 1.92 for HADS-A; RR 1.76, 95% CI 1.43–2.17 for HADS-D, both p<0.001). HADS-A/D ⩾8 each predicted future hospitalisation (HR 1.30, 95% CI 0.98–1.72, p=0.067 for HADS-A; HR 1.40 95% CI 1.04–1.88, p=0.027 for HADS-D). Interpretation Anxiety and depression are common in bronchiectasis, correlate with disease severity and predict poor outcomes. Consideration of psychological comorbidities should be evaluated in routine bronchiectasis care.
Author(s): De Soyza A, Saunders T, Wild G, Mawson P, Kelly M, Elborn S, Hill AT, Gatheral T, Sullivan A, Haworth C, Hurst JR, Brown J, Carroll M, Navaratnam V, Loebinger M, Davies G, Upadhyay H, Bradley J, Walker PP, Steer J, Duckers J, Pollock J, Crichton M, Chalmers JD, McNally R
Publication type: Article
Publication status: Published
Journal: ERJ Open Research
Year: 2025
Volume: 11
Issue: 3
Online publication date: 27/05/2025
Acceptance date: 04/09/2024
Date deposited: 03/10/2024
ISSN (electronic): 2312-0541
Publisher: European Respiratory Society
URL: https://doi.org/10.1183/23120541.00348-2024
DOI: 10.1183/23120541.00348-2024
ePrints DOI: 10.57711/gg71-6m68
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