The prevalence and risk factors for anxiety/depression in patients with connective tissue disease (CTD) associated interstitial lung diseases (ILDs)

Background: Connective tissue disease(CTD) associated interstitial lung diseases (ILDs) is a common chronic disease. Given that anxiety and depression are prevalent in patients with chronic diseases, this study aimed to explore the prevalence of anxiety/depression in CTD-ILD patients, and identify its associated risk factors. Methods This study is based on the ICE study (Interstitial lung disease in West China Hospital: a 24-month prospective C ohort in the real world). The anxiety and depression symptoms were evaluated in CTD-ILD patients using Hamilton Anxiety/Depression Rating Scale (HAM-A/D), respectively. Demographic data, clinical symptoms, pulmonary function, and radiological data were collected. Multivariate analysis was performed to identify the independent risk factors of anxiety/depression in CTD-ILD patients. Result A total of 118 patients with CTD-ILD were enrolled. Among them, 66 patients (55.93%) with anxiety symptoms (HAM-A > 7), 55 patients (46.61%) with depression symptoms (HAM-D > 8), while 51patients (43.22%) with both anxiety and depression symptoms. Muscle soreness (OR = 3.451, 95% CI: 1.147–10.384, P  = 0.028) is significantly associated with anxiety. And muscle soreness (OR = 4.337, 95% CI: 1.43–13.154, P  = 0.01), Raynaud's phenomenon (OR = 4.264, 95% CI: 1.355–13.424, P  = 0.013), and lower FVC% predicted (OR = 1.768, 95% CI: 1.152–2.714, P  = 0.018) are significantly associated with depression. Besides, muscle soreness (OR = 4.737, 95% CI: 1.451–15.463, P  = 0.010), lower FVC% predicted (OR = 1.649, 95% CI: 1.067–2.549, P  = 0.024) and more severe dyspnea scaled by mMRC score (OR = 1.725, 95% CI: 1.075–2.769, P  = 0.024) were associated with comorbid depression and anxiety. Conclusion Anxiety and depression were common in CTD-ILD patients. Impaired respiratory physiology (reduced FVC% predicted, dyspnea) and CTD related symptoms (Raynaud's phenomenon and muscle soreness) were risk factors for anxiety and depression in CTD-ILD patients, which emphasize the importance of focusing on the management of psychological disorders in CTD-ILD patients.