Anxiety, depression common in patients with nontuberculous mycobacterial pulmonary disease

In a new study, both anxiety and depression were common in patients with nontuberculous mycobacterial pulmonary disease and were associated with respiratory and systemic symptoms.

“Nontuberculous mycobacterial pulmonary disease could amplify negative emotions among patients, leading to anxiety and depression. The presence of anxiety and depression could be related to the lack of medication adherence and a low health-related quality of life in patients with nontuberculous mycobacterial pulmonary disease,” Hae In Jung, MD, from the division of pulmonary and critical care medicine at the Seoul National University Hospital, South Korea, and colleagues wrote in Chest. “However, the prevalence of anxiety and depression in patients with nontuberculous mycobacterial pulmonary disease is unknown.”

The study included 368 patients diagnosed with nontuberculous mycobacterial pulmonary disease (mean age, 62.5 years; 67.7% women) from July 2011 to December 2019. All patients were in Seoul National University Hospital’s prospective cohort and completed the Hospital Anxiety and Depression Scale (HADS) at least twice. Follow-up occurred every 3 to 6 months, during which chest radiography was performed and sputum samples were collected at each visit. Using these data, researchers identified factors associated with anxiety and depression in this population.

Overall, 22.8% of patients had anxiety (HADS anxiety score 8) and 22.5% of patients had depression (HADS depression score 8).

The presence of cough (adjusted OR = 2.01; 95% CI, 1.19-3.39) and febrile sensation (aOR = 4.45; 95% CI, 2.13-9.3) were associated with anxiety. In addition, 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.

Forty-four percent of patients were treated with antibiotics. Patients who had anxiety (P = .006) or depression (P = .004) received treatment with antibiotics more frequently (anxiety, 57.1%; depression, 57.8%) compared with patients without anxiety or depression (40.1% and 40%, respectively). Treatment discontinuation was observed among 25% of patients with anxiety and 27.1% of patients with depression. During the study period, only 6% of patients with anxiety and 4.8% of patients with depression received psychiatric consultation.

Researchers observed no difference in treatment outcomes depending on a patient’s initial anxiety or depression status.

According to the researchers, at the time of enrollment and during the follow-up period, HADS scores of patients with anxiety and depression were higher compared with patients without anxiety and depression. However, these HADS scores significantly declined within 1 year after enrollment.

“Early screening for anxiety or depression among high-risk patients with nontuberculous mycobacterial pulmonary disease and the implementation of countermeasures are warranted,” the researchers wrote. “However, in our study, these screenings did not lead to psychological intervention in most of patients with anxiety or depression.”