Anxiety and Depression in Patients With Nontuberculous Mycobacterial Pulmonary Disease: A Prospective Cohort Study in South Korea

Abstract

© 2021 American College of Chest PhysiciansBackground: The mental health of patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) has been underestimated. Research Question: What is the prevalence of, associated factors for, and clinical impact of anxiety and depression in patients with NTM-PD? Study Design and Methods: Among patients diagnosed with NTM-PD between July 1, 2011, and December 31, 2019, who were part of Seoul National University Hospital's prospective cohort, this study included those who completed the Hospital Anxiety and Depression Scale (HADS) at least twice. Multivariable logistic regression analysis was used to identify the factors associated with anxiety and depression. Multilevel mixed effects regression was used to analyze longitudinal trends of the HADS scores. Results: A total of 368 patients were included in this study, including 84 (22.8%) with anxiety (Hospital Anxiety and Depression Scale-Anxiety score ≥ 8) and 83 (22.5%) with depression (Hospital Anxiety and Depression Scale-Depression score ≥ 8). The presence of cough (adjusted OR [aOR], 2.01; 95% CI, 1.19-3.39) and febrile sensation (aOR, 4.45; 95% CI, 2.13-9.30) were associated with anxiety, whereas dyspnea (aOR, 4.13; 95% CI, 1.38-12.37) and febrile sensation (aOR, 2.91; 95% CI, 1.38-6.13) were associated with depression. Although the HADS scores of patients with anxiety or depression at the time of enrollment and throughout the follow-up period were higher than those without, these scores declined significantly within 1 year following enrollment. Patients with anxiety (P = .006) or depression (P = .004) received antibiotic treatment more frequently than those without. Treatment outcomes did not differ depending on the initial anxiety or depression status. Interpretation: Anxiety and depression were common in patients with NTM-PD and were associated with patient-reported symptoms. Although these persisted over time, the treatment outcomes did not differ. Clinical Trial Registration: ClinicalTrials.gov; No.: NCT01616745; URL: www.clinicaltrials.gov.