P203 Correlation of Nijmegen score and hospital anxiety/depression (HAD) score in dysfunctional breathlessness

Abstract

Introduction: Dysfunctional Breathlessness has an incidence of about10% among the general population and can often coexist with otherchronic cardio respiratory illness. Patients often have a degree ofanxiety or depression and may pose a diagnostic and therapeutic challenge. Nijmegen questionnaire is suitable as a screening tool forearly detection and also as an aid in diagnosis and therapy planning.Aim To test the correlation between the Nijmegen score and thehospital anxiety/depression score in patients diagnosed withdysfunctional breathlessness.Method The diagnosis was made on the basis of exclusion with anormal clinical examination, lung function and echocardiogram, orwith symptoms disproportionate to measurements of severity oftheir respiratory illness. The physiotherapist further assessedpatients with particular regard to their breathing pattern and theNijmegen (Ni) score, with a score over 23 being regarded as diagnostic.Consecutive patients referred to the clinic over 24 monthswere reviewed. The following parameters were analysed- demographics,underlying respiratory illness, breathing and sleep pattern,Nijmegen score (Pre and Post Intervention), HAD scores and theinterventional modalities. Result(s): 51 patients (males 20, females 31) were assessed. The meanage at presentation was 60.2 (range 20e84). 26/51 patients hadchronic cardio respiratory illness. 28/51 patients had an abnormalbreathing pattern, the most common being frequent sighing. 23/51patients reported abnormal sleep pattern, frequent awakening beingthe commonest. 37 patients (males 17, females 20) had a preintervention Ni score over 23 (mean 29, range 23-42). Interventionsincluded patient education, cognitiveebehavioural therapy,breathing exercises and training in a physiotherapist led clinic. Theinterventional period was 6 weeks and post 6 weeks the Nijmegenscore fell below the diagnostic threshold in 29/37 patients (meanreduction 14, range 3-22, p value<0.001). HAD scores was used toassess the degree of mood impairment and there was no linearcorrelation (Pearson correlation) (Abstract P203 table 1) with the preintervention Nijmegen score. (Table presented).