Anxiety, Depression, and Mortality in COPD: What’s the Connection?

Individuals with chronic obstructive pulmonary disease (COPD) who have symptoms of anxiety or depression may be at an increased risk for mortality compared with their counterparts who do not have such symptoms, according to new findings. 

To reach this conclusion, the researchers recruited 2076 individuals with COPD from the second (1995-1997) and third (2006-2008) surveys of the HUNT Study. To assess for mortality, the individuals were followed until January 2019.

Using the Hospital Anxiety and Depression Scale (HADS), the researchers assessed the patients’ baseline status of anxiety or depression. Probable cases were defined by a score of 8 or greater.

Among all the patients with COPD, 16.2% had symptoms of anxiety and 15.9% had symptoms of depression.

Compared with a HADS anxiety (HADS-A) or HADS depression (HADS-D) score less than 8, symptoms of anxiety or depression increased mortality by 21%.

However, improving symptoms of anxiety over time may lower that mortality.

According to the researchers, over the approximately 11-year period between surveys, a change of HADS-A from 8 or greater to less than 8 was associated with a decrease in mortality.

Such an association between lower mortality and change in HADS-D was not observed.

—Colleen Murphy


Vikjord SAA, Brumpton BM, Mai XM, Vanfleteren L, Langhammer A. The association of anxiety and depression with mortality in a COPD cohort. The HUNT study, Norway. Respir Med. Published online August 4, 2020. doi:10.1016/j.rmed.2020.106089