RELATIONSHIP BETWEEN DYSPNEA IN DAILY-LIFE AND PSYCHOPHYSIOLOGICAL STATE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE DURING LONG-TERM DOMICILIARY OXYGEN-THERAPY

We examined the relationships among dyspnea ratings in daily life, the physiologic state, and anxiety and depression of fifty-two patients w ith chronic obstructive disease (COPD) during long-term domiciliary ox ygen therapy (LTOT). Clinical ratings of dyspnea were assessed by the visual-analog scale (VAS) during eight types of basic behavior in indo or daily life, Analysis of the physiologic state included forced expir atory volume in 1 second (FEV(1.0)), and arterial blood gas (PaO2, PaC O2) at rest while breathing room air. The hospital anxiety and depress ion (HAD) scale, which consists of 14 questions, was used to assess th e degree of anxiety (HAD-A) and depression (HAD-D). The mean age of th e patients was 69.5+/-10.8 year (SD), and the duration of LTOT was 944 +/-739 days. The mean values were 0.77+/-0.45 L for FEV(1.0), 57.7+/-7 .4 Torr for PaO2, and 47.4+/-8.1 Torr for PaCO2. FEV(1.0) was correlat ed with PaCO2 (r=-0.548, p<0.0001), but it was not correlated with PaO 2. High correlation was noted between HAD-A and HAD-D (r=0.693, p<0.00 01), whereas correlation was not noted between HAD and the physiologic state. VAS was significantly correlated with FEV(1.0) (r=0.320, p<0.0 5), as well as with HAD-A (r=0.358, p<0.01) and HAD-D (r=0.444, p<0.01 ). Dyspnea ratings were found to be influenced by anxiety and the depr ession state, and also by the degree of Bow limitation in patients wit h COPD during LTOT. In contrast, the physiologic state scarcely influe nced the anxiety and depression state. Thus, psychotherapy may play an important role in the reduction of dyspnea sensation, which is an imp ortant determinant of quality of life.