PSYCHIATRIC MORBIDITIES IN PATIENTS OF COPD AND BRONCHIAL ASTHMA ATTENDING OPD OF TERTIARY CARE HOSPITAL

BACKGROUND Chronic pulmonary diseases are a global health problem and the number of patients being treated in primary care settings is increasing. The prevalence of a life-time diagnosis of asthma has increased in all age groups. There has been a dramatic shift in the conceptualization and treatment of asthma and COPD in the last 50 years. Psychiatric disorders, especially anxiety disorders, are very common in patients with asthma and COPD. Anxiety is also common in COPD and is related to some of the same factors described for asthma including the psychological response to the experience of breathlessness as well as side effects of beta-agonists. Since there is paucity of relevant data from Kashmir, this study was designed to find the co morbidity in patients of COPD and Asthma in a tertiary care teaching hospital in Srinagar, Kashmir. METHODS Sixty successive patients presents with history of thirty each of asthma and COPD who fulfilled inclusion and exclusion criteria were taken up for the study and administered the Hamilton depression rating scale (HAM-D) and Hamilton Anxiety rating scale (HAM-A) scales for evaluation of depressive disorder and anxiety disorder. Each patient was informed about the purpose of interview; his/her consent was obtained and strict confidentiality was ensured. General description, demographic data and psychiatric history were recorded using semi structured Proforma and HAM-A and HAM-D. RESULTS Out of sixty cases of COPD and Bronchial Asthma, 50% of the patients were in the age group of 66-80 followed by 35% in age group of 81-85 years. This could suggest that COPD and Bronchial Asthma is a problem of old age. There were predominantly more males (65%) than females (35%) in our study. Representations of gender, religion, family type and marital status have been found to be in accordance with socio-demographic profile of our country. Out of sixty cases of COPD and Bronchial Asthma, 35% of the patients were educated up to the primary level and 50% had poor social support. This reflects that low literacy rate along with presence of social support are factors of importance in COPD and Bronchial Asthma. DISCUSSION Depression was found in 35% of patients while anxiety disorder was found in majority of patients of 65%.