Anxiety and depression status in patients with idiopathic pulmonary fibrosis and outcomes of nintedanib treatment: an observational study

Abstract

Background

Anxiety and depression are common comorbidities in idiopathic pulmonary fibrosis (IPF) that impair health-related quality of life. However, there is a lack of studies focusing on the mental disorder of IPF after antifibrotic treatment and their related predictive factors.

Methods

Patients with an initial diagnosis of IPF were enrolled. Data on demographics, lung function, Generalized Anxiety Disorder-7 (GAD-7) Scale, Patient Health Questionnaire 9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and St. George's Respiratory Questionnaire total score(SGRQ-T) were collected. Changes in anxiety, depression, somatic symptoms, and quality of life scores before and after nintedanib treatment were compared, and the related predictive factors were analyzed.

Results

A total of 56 patients with a first diagnosis of IPF were enrolled, with 42 and 35 patients suffering from anxiety and depression, respectively. The GAD-7, PHQ-9, PHQ-15, and SGRQ scores were higher in the anxiety and depression groups. SGRQ total score (SGRQ-T) [OR = 1.075, 95%CI= (1.011, 1.142)] was an independent predictor of IPF combined with anxiety (p < 0.05); SGRQ-T [OR = 1.080, 95%CI= (1.001, 1.167)] was also an independent predictor of IPF combined with depression (p < 0.05). After treatment, GAD-7, PHQ-9, PHQ-15, and SGRQ scores decreased (p < 0.05). ΔSGRQ-T significantly affected ΔGAD-7 (β = 0.376, p = 0.009) and ΔPHQ-9 (β = 0.329, p = 0.022).

Conclusion

Anxiety and depression in IPF patients are closely related to somatic symptoms, pulmonary function, and quality of life. The SGRQ-T score is of great value for assessing anxiety and depression in patients with IPF. Short-term treatment with nintedanib antifibrotic therapy can alleviate anxiety and depression in IPF patients.

Keywords:

• Idiopathic pulmonary fibrosis
• anxiety
• depression
• quality of life
• antifibrotic therapy

Authors contributions

Conception and design: X. He, Z Pei, L Guo; administrative support: L Guo; provision of study materials or patients: L Guo, J Ji, H Yan, Z Pei; collection and assembly of data: X He, S Fang, Z Luo, Z Pei, X Liu, Y Lei; data analysis and interpretation: X He, J Ji, Z Pei, L Guo; manuscript writing: all authors; and final approval of the manuscript: all authors.

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China (No. 2017-171). Written informed consent was obtained from all patients or their guardians before enrolment in the study. The study was conducted in accordance with the principles established in the Declaration of Helsinki and the International Council for Harmonisation Guidelines for Good Clinical Practice.

Consent to publication

Authors are all agreed to publication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The dataset used in this study is available from the corresponding author upon reasonable request.

Additional information

Funding

This study was supported by Respiratory Diseases Specific Cohort Study of Precision Medicine Research under National Key Research and Development Program (PORTRAY STUDY) (No. 2016YFC0901101) and Scientific Research Project of Sichuan Medical and Healthcare Promotion Institute (No. KY2022SJ0116).