Depression and Anxiety May Worsen Quality of Life, Lung Function of Patients with Pulmonary Sarcoidosis, Study Says

Depression and Anxiety May Worsen Quality of Life, Lung Function of Patients with Pulmonary Sarcoidosis, Study Says

Depression and anxiety may worsen the quality of life and lung function of patients with pulmonary sarcoidosis, a study has found.

The findings of the study, “Psychological burden associated with worse clinical outcomes in sarcoidosis,” were published in the journal BMJ Open Respiratory Research.

Statistics indicate that 18% to 66% of patients diagnosed with sarcoidosis experience depression, and approximately a third (31% to 33%) struggle with anxiety. These values are higher than in the general population.

“In other chronic pulmonary illnesses, psychological symptoms are associated with lower health-related quality of life (HRQoL) independent of disease severity,” the researchers wrote. “Depressive symptoms have been correlated with lower HRQoL in patients with sarcoidosis; however, these studies have not evaluated the association while controlling for other factors such as disease severity.”

“Patients with sarcoidosis requiring treatment have higher rates of depressive symptoms and worse quality of life compared with asymptomatic patients, suggesting those requiring treatment should be evaluated separately,” the researchers added.

In the study, a team from Johns Hopkins University in Baltimore set out to investigate the possible link between the high prevalence of depression and anxiety and worse clinical outcomes in patients with pulmonary sarcoidosis requiring treatment.

“We hypothesized that psychological symptoms would be associated with an increased odds of healthcare utilization, worse HRQoL, and worse pulmonary function,” the investigators wrote.

The study involved a total of 112 adult patients (median age of 57 years) who had been diagnosed with pulmonary sarcoidosis, and were receiving treatment at the Johns Hopkins Sarcoidosis Clinic. The degree of anxiety, depression, healthcare utilization, and health-related quality of life were all evaluated through questionnaires that the participants were asked to complete.

Survey findings revealed that 34% of the patients enrolled in the study had mild depression, and 20% had moderate-to-severe depression. In addition, a fourth (25%) of the participants had mild anxiety, and 12% had moderate-to-severe anxiety.

Statistical analyses showed that patients who had moderate-to-severe depression or anxiety were more likely (8.87 times for those with depression, and 13.05 times for those with anxiety) to have visited the hospital’s emergency department in the last six months, and to have worse HRQoL, compared to those who had no symptoms of anxiety or depression.

In addition, the investigators found that patients who had moderate-to-severe depression tended to have worse lung function, as reflected by a lower carbon monoxide diffusion capacity, or DLCO (which measures the amount of oxygen that is transferred from the lungs to the blood), than those who had no symptoms of depression.

No clear associations were found between depressive or anxiety symptoms and the chances of hospitalization, or the scores of other parameters commonly used to evaluate lung function, including forced vital capacity and forced expiratory volume in one second.

“Our study confirms previous findings of high rates of psychological symptoms among sarcoidosis patients,” the researchers wrote. “Given the burden of psychological symptoms in sarcoidosis, and its associations with clinical outcomes, screening and treating for depression and anxiety may be especially important” in order to reduce acute healthcare utilization by patients and to improve their quality of life.

The researchers noted, however, that future studies are still needed to better understand the impact that depression and anxiety may have on clinical outcomes in patients with sarcoidosis.

 

Joana is currently completing her PhD in Biomedicine and Clinical Research at Universidade de Lisboa. She also holds a BSc in Biology and an MSc in Evolutionary and Developmental Biology from Universidade de Lisboa. Her work has been focused on the impact of non-canonical Wnt signaling in the collective behavior of endothelial cells — cells that make up the lining of blood vessels — found in the umbilical cord of newborns.
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Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.
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Joana is currently completing her PhD in Biomedicine and Clinical Research at Universidade de Lisboa. She also holds a BSc in Biology and an MSc in Evolutionary and Developmental Biology from Universidade de Lisboa. Her work has been focused on the impact of non-canonical Wnt signaling in the collective behavior of endothelial cells — cells that make up the lining of blood vessels — found in the umbilical cord of newborns.
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One comment

  1. When I was first diagnosed with Sarcoidosis I was really sick. My PFTs were rather low, but my Diffusion capacity was really low, and my lungs were almost white out on CT. I responded rapidly to high dose steroids, but when the steroids were reduced, the condition quickly returned– I was short of breath talking, and would get so tired that I would stop my car halfway home and take a nap… Steroids returned me to close to normal. They also made me so hungry that I would shake… and my weight quickly went from 170# to 320#, and Brooks Brothers could no longer fit me in a business suit. As a physician who has run weight loss clinics in the past… I did a goofy thing- went on a high fat, high protein diet allowing fresh fruit (not citrus- and watch) and fresh
    veggies at will. I set out to walk an hour twice a day- starting at a leisurely pace. I also took off from my desk job (I am a physician) and managed my sleep to include at least 8-9 hours a night. I did drop from 320 down to 180 over the course of about 8 months or so— I am now down to 160# but that has come more slowly. I was stuck at 180 pounds eating healthy but I was acting like a diabetic— started on methotrexate and a glucose continuous monitor–and I was able to reduce my prednisone from 20 a day to 5, and in the process, my appetite returned to normal and I have weaned off diabetic medications including insulin while my average blood sugar is now 122, and A1C is less than 6, and I am continuing to lose weight. My point is that Prednisone causes people to lose weight and become diabetic sometimes, and Insulin causes weight gain in a lot of people. The usual 15 calories per pound of ideal weight per day, with 30% protein, and then 30% fat with 40% carbohydrate divided into simple sugars as in fruit and complex sugars like pasta works well for most people, but may need further consultation in people on steroids with sarcoidosis. I am now at 162# and still losing weight at about a pound a week.

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