Anxiety, depression, physical disease parameters and health-related quality of life in the BronchUK national bronchiectasis cohort
De Soyza, Anthony Saunders, Tess Wild, Georgina Mawson, Phil Kelly, Martin Elborn, Stuart Hill, Adam T Gatheral, Tim Sullivan, Anita Haworth, Charles
De Soyza, Anthony
Saunders, Tess
Wild, Georgina
Mawson, Phil
Kelly, Martin
Elborn, Stuart
Hill, Adam T
Gatheral, Tim
Sullivan, Anita
Haworth, Charles
Affiliation
Newcastle University; Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust; Western Health and Social Care Trust; Queens University of Belfast; University of Edinburgh; University Hospitals of Morecambe Bay NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust; Royal Papworth Hospital NHS Foundation Trust; University College London; University of Southampton; University Hospital Southampton NHS Foundation Trust; Sir Charles Gardiner Hospital; Guy’s and St Thomas’ NHS Foundation Trust; Newcastle Upon Tyne Hospitals NHS Foundation Trust; University of Liverpool; NHS University Hospitals of Liverpool Group; Northumbria Healthcare NHS Foundation Trust; Cardiff and Vale University Health Board; University of Dundee
Other Contributors
Publication date
2025-05-27
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
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.
Citation
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. Anxiety, depression, physical disease parameters and health-related quality of life in the BronchUK national bronchiectasis cohort. ERJ Open Res. 2025 May 27;11(3):00348-2024. doi: 10.1183/23120541.00348-2024.
Type
Article