The impact of anxiety, depression and living alone in chronic obstructive pulmonary disease

Objective: This prospective longitudinal study examined whether quality of life as measured by the disease specific chronic respiratory questionnaire (CRQ) and living alone, at the time of prescription of long-term oxygen therapy (LTOT), impacted on the mortality of patients with severe chronic obstructive pulmonary disease (COPD). Methods: One-hundred and fifty-seven patients, (male:female, 74:83) with severe COPD, aged under 80 years completed the CRQ at the time of prescription of LTOT. Demographic and physiological parameters were also collected. The patients were followed in outpatient clinics after commencing LTOT. Results: Kaplan-Meier analysis of the data demonstrated a relationship between the emotional function score of the CRQ at the commencement of LTOT and survival on LTOT for female patients. Living with a partner was associated with an additional 12 months of life. When known physiological predictors of survival, the CRQ dimensions and living alone were included in a Cox's proportional hazard model, emotional function, body mass index and forced vital capacity were independent prognostic indicators for females, and arterial partial pressure of oxygen for males. Conclusion: Our results suggest that poor emotional functioning of female patients with severe COPD at the time of prescription of LTOT is associated with increased mortality.