2026/03/01 by Zhe Wu, Karen Moor, Marlies Wijsenbeek +5
Medicine · #Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis #Chronic Obstructive Pulmonary Disease (COPD) Research #Pulmonary Hypertension Research and Treatments
paper · doi:10.1016/j.chest.2026.03.016
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a debilitating, life-limiting fibrotic lung disease. Symptoms including breathlessness, cough, and fatigue, together with disease severity, contribute to psychological burden, yet their relationship with anxiety and depression remains unclear. RESEARCH QUESTION: In patients with IPF, what is the prevalence and severity of anxiety and depression, and what are their associations with symptoms and disease severity? STUDY DESIGN AND METHODS: This observational study prospectively recruited patients with incident IPF. Hospital Anxiety and Depression Scale (HADS), Dyspnea-12, Leicester Cough Questionnaires, cough visual analog scales, Living with IPF (L-IPF), and lung function were assessed at baseline and 12 months. RESULTS: Two hundred sixty-nine patients with IPF (mean age, 73.5 years; 81% male) were recruited; 157 completed follow-up. Mean FVC % predicted ± SD was 79% ± 14.7%. At baseline, the prevalence of anxiety and depression (HADS score ≥ 8) was 27.5% and 28.3%, respectively (suggestive HADS 8-10: 18.6% and 14.9%; probable HADS ≥ 11: 8.9% and 13.3%, respectively). On multivariable analysis, worse Dyspnea-12 and poorer L-IPF energy were independent factors for both anxiety and depression at baseline; younger age was a factor for anxiety. Baseline lung function did not correlate with HADS anxiety or HADS depression. At follow-up, HADS anxiety scores increased numerically, below reported minimal clinically important difference values, with no change in HADS depression scores. Younger age, higher Dyspnea-12 scores, and poorer L-IPF energy were associated with greater increases in anxiety. Moderate or weak correlations were observed between changes in HADS and longitudinal changes in patient-reported outcomes (worsening breathlessness, cough, and energy levels). Changes in FVC % predicted did not correlate with HADS. INTERPRETATION: Our results show that anxiety and depression are common in patients with IPF and are associated with more dyspnea and lower energy. The mental health burden experienced by patients with IPF needs better recognition and might be helped by targeted symptom management.