Observational studyMedical sciences (Basel, Switzerland)2026
Psychological Distress in COPD Assessed by DASS-21-R: Multivariable Regression and Bayesian Analysis Across GOLD Stages.
Observational study in Medical sciences (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
backgroundPsychological distress is a common comorbidity in chronic obstructive pulmonary disease (COPD), yet its relationship with disease severity remains incompletely understood. This study aimed to assess depression, anxiety, and stress using the Depression Anxiety Stress Scales-21 (DASS-21) and to examine their distribution across COPD severity stages.
methodsThis multicenter, cross-sectional observational study included 285 clinically stable COPD patients enrolled between 2023 and 2025. COPD severity was classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Multinomial and binary logistic regression models were constructed to identify independent predictors of COPD severity and clinically significant psychological distress, adjusting for demographic and clinical covariates. Bayesian independent sample analyses and ANOVA effect size estimates were additionally performed.
resultsSmoking exposure was independently associated with advanced COPD stages (GOLD 4 vs. GOLD 1-3: aOR 1.05,
conclusionsPsychological distress is prevalent across all COPD severity stages and is not independently determined by airflow limitation. Symptom burden rather than spirometric severity appears to be more closely associated with emotional outcomes.
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