Abstract
Background: Post-Traumatic Stress Disorder (PTSD) is a common psychological
consequence of exposure to traumatic stressful life events. During COPD exacerbations
dyspnea can be considered a near-death experience that may induce post-traumatic
stress symptoms. The aim of this study was to evaluate the relationship between
COPD exacerbations and PTSD- related symptoms. Method: Thirty-three in-patients
with COPD exacerbations were screened for the following: PTSS (Screen for
Posttraumatic Stress Symptoms), anxiety (Beck Anxiety Inventory) and depression (Beck
Depression Inventory). Patients had a median age of 72 years and 72.7% were female.
Results: Mean FEV1 and FVC were 0.8±0.3 (37.7 ± 14.9% of predicted) and 1.7 ± 0.6 (60 ±
18.8% of predicted), respectively with a mean exacerbation of 2.9 episodes over the past
year. Post-traumatic stress symptoms related to PTSD were found in 11 (33.3%) patients
(SPTSS mean score 4.13 ± 2.54); moderate to severe depression in 16 (48.5%) (BDI mean
score 21.2 ± 12.1) and moderate to severe anxiety in 23 (69.7%) (BAI mean score 23.5 ±
12.4). In a linear regression model, exacerbations signifi cantly predicted post-traumatic
stress symptoms scores: SPTSS scores increased 0.9 points with each exacerbation
(p = 0.001). Signifi cant correlations were detected between PTSD-related symptoms
and anxiety (rs = 0.57; p = 0.001) and PTSD symptoms and depression (rs = 0.62; p =
0.0001). In a multivariable analysis model, two or more exacerbation episodes led to a
near twofold increase in the prevalence ratio of post-traumatic stress symptoms related
to PTSD(PR1.71; p = 0.015) specially those requiring hospitalization (PR 1.13; p = 0.030)
Conclusion: PTSD symptoms increase as the patient’s exacerbations increase. Two or
more exacerbation episodes lead to a near twofold increase in the prevalence ratio
of post-traumatic symptomatology. Overall, these fi ndings suggest that psychological
domains should be addressed