Screening Tools for Depression and Anxiety in Patients with Chronic Obstructive Pulmonary Disease – A Systematic Review

Figures & data

Figure 1. PRISMA flow chart of the study selection process.

Table 1. Overview of data from included studies.

Author, Year of publication, Country of origin	Study design	Population	Screening tools	Diagnostic interview	Prevalence of anxiety and/or depression	Sensitivity/specificity
Aydin et al., 2001, Turkey [10]	Cross sectional	N = 38 (38 men). Mean age: 48.5 years	GHQ-12	CIDI	Depression: 39.5% Anxiety: 15.8%	83.3/80.0%
Baker et al., 2008, USA [14]	Prospective, multi-center, cohort	N = 219 (118 men). Mean age: 65 years	AIR GAD-7 HADS-A	MINI	Anxiety: 11%	AIR: 66/65% GAD7: 78/77% HADS-A: 63/85%
Cheung et al., 2012, New Zealand [13]	Cross sectional	N = 55 (25 men). Mean age: 72.7 years.	GAI HADS-A	MINI	Anxiety: 25.5%	HADS-A: 78.6/70.7% GAI: 85.7/78.0%
Julian et al., 2009, USA [8]	Cross sectional	N = 188 (113 women). Mean age 66 years	GDS-15	MINI	Minor depression: 12.2% Major depression: 11.2%	Sensitivity, major depression: 81% Specificity, major depression: 87%
Phan et al., 2016, Australia [9]	Cross sectional	N = 56 (23 men). Mean age 73 years.	HADS-D BDI-II HADS-A BAI	MINI	Major depression: 16.1% Anxiety: 25%	HADS-D: 78/81% After removal of Q4: 100/83% BDI-II: 89/77% After removal of Q21: 100/79% HADS-A:71/81% BAI: 89/62%
Stage et al., 2003, Denmark [11]	Cross sectional	N = 49 (33 women). Mean age 71 years.	HDSS	Diagnosis established according to ICD-10 criteria	Depression: 47%	91/88%
Yohannes et al., 2000, England [12]	Cross sectional	N = 137 (69 men). Mean age 73 years.	BASDEC	GMS	Depression: 42%	100/93%

AIR: Anxiety Inventory for Respiratory Disease; BDI-II: Beck Depression Inventory; BAI: Beck Anxiety Inventory; BASDEC: Brief Assessment Schedule Cards; CIDI: Composite International Diagnostic Interview; COPD: Chronic obstructive pulmonary disease; GAD-7: Generalised Anxiety Disorder 7-Item Scale; GAI: Geriatric Anxiety Inventory; GDS-15: Geriatric Depression Scale 15-Item; GHQ-12: General Health Questionnaire 12; GMS: Geriatric Mental State Schedule; HADS-A: Hospital Anxiety and Depression Scale–Anxiety; HADS-D: Hospital Anxiety and Depression Scale–Depression; HDSS: Hamilton Depression Subscale; ICD: International Statistical Classification of Diseases and Related Health Problems; MINI: Mini-International Neuropsychiatric Interview; MMSE: Mini-Mental State Examination; MoCA: The Montreal Cognitive Assessment.

Aydin IO, Ulaşahin A. Depression, anxiety comorbidity, and disability in tuberculosis and chronic obstructive pulmonary disease patients: applicability of GHQ-12. Gen Hosp Psychiatr. 2001;23(2):77–83.

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Baker AM, Holbrook JT, Yohannes AM, et al. Test performance characteristics of the AIR, GAD-7, and HADS-Anxiety screening questionnaires for anxiety in chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2018;15(8):926–934. DOI:https://doi.org/10.1513/AnnalsATS.201708-631OC

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Cheung G, Patrick C, Sullivan G, et al. Sensitivity and specificity of the geriatric anxiety inventory and the hospital anxiety and depression scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease. Int Psychogeriatr. 2012;24(1):128–136. DOI:https://doi.org/10.1017/S1041610211001426

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Julian LJ, Gregorich SE, Earnest G, et al. Screening for depression in chronic obstructive pulmonary disease. COPD. 2009;6(6):452–458. DOI:https://doi.org/10.3109/15412550903341463

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Phan T, Carter O, Adams C, et al. Discriminant validity of the hospital anxiety and depression scale, beck depression inventory (II) and beck anxiety inventory to confirmed clinical diagnosis of depression and anxiety in patients with chronic obstructive pulmonary disease. Chron Respir Dis. 2016;13(3):220–228. DOI:https://doi.org/10.1177/1479972316634604

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Stage KB, Middelboe T, Pisinger C. Measurement of depression in patients with chronic obstructive pulmonary disease (COPD). Nord J Psychiatry. 2003;57(4):297–301. DOI:https://doi.org/10.1080/08039480310002147

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Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire. Int J Geriat Psychiatry. 2000;15(12):1090–1096. DOI:https://doi.org/10.1002/1099-1166(200012)15:12<1090::AID-GPS249>3.0.CO;2-L

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