Prevalence and Predictors of Depression and Anxiety in Patients With Fibrotic Interstitial Lung Disease: A Prospective Cohort Study
Bibliographic record
Abstract
Abstract Background Interstitial lung disease (ILD) consists of a large group of lung diseases with high mortality and reduced quality of life. Previous small studies have reported depression and anxiety in up to 60% of patients, but their prevalence in specific subgroups is unknown and there is little understanding of what drives these disorders. Methods Patients with ILD were identified from the Canadian Registry for Pulmonary Fibrosis. Patient reported history of depression, anxiety, and other comorbidities were recorded based on a standardized review of the clinical record at the time of ILD diagnosis. Medications used to treat depression and/or anxiety were recorded and categorized by class (selective serotonin reuptake inhibitor, serotonin and norepinephrine reuptake inhibitor, tricyclic antidepressant, antipsychotic, and benzodiazepine). Presence of a self-reported diagnosis or medication use were used to classify patients as having depression and/or anxiety. Multivariable logistic regression models tested association of presence of depression and/or anxiety with age, sex, smoking pack-years, forced vital capacity (FVC%), and diffusion capacity of the lung for carbon monoxide (DLCO%). Results The study population consisted of 3,988 patients, including 31% with idiopathic pulmonary fibrosis (IPF), 41% with connective tissue disease-associated ILD (CTD-ILD), 9% with fibrotic hypersensitivity pneumonitis (fHP), and 19% with unclassifiable ILD. Mean age was 65±12 years, 2,002 (50%) were female, mean smoking pack years was 25±22, and 649 (16%) used oxygen. Depression and/or anxiety was present in 701 (18%) patients in the total cohort, including 17% with IPF, 15% with CTD-ILD, 23% with fHP, and 22% with unclassifiable ILD. In unadjusted analysis, the presence of depression and/or anxiety was associated with female sex (OR 1.79, 95% CI 1.51 to 2.12, p<0.001) and oxygen use (OR 1.45, 95% CI 1.16 to 1.79, p<0.001). Female sex was an independent predictor of depression and/or anxiety in all ILD diagnosis subgroups (Table), with increased smoking pack-years also independently associated with presence of depression and/or anxiety in CTD-ILD and unclassifiable ILD. Conclusions Depression and/or anxiety is present in 18% of patients with fibrotic ILD and is more common in females. These findings highlight the importance of a comprehensive approach to patient care that specifically addresses the possible presence of mood disorders.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".