{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:44:01Z","timestamp":1790963041681,"version":"4.1.0"},"reference-count":57,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Princess Nourah bint Abdulrahman University","award":["PNURSP2023R 286"],"award-info":[{"award-number":["PNURSP2023R 286"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The role of anxiety and depression in functional performance during walking in patients with chronic obstructive pulmonary disease (COPD) is controversial. In this cross-sectional study, we aimed to assess the effects of anxiety, depression, and health-related quality of life (HRQOL) on the functional performance of this patient population. Seventy COPD patients aged 63 \u00b1 11 years participated in the study. To measure their functional performance, the six-minute walk test (6MWT) was used. Anxiety and depression were assessed using two questionnaires: the Anxiety Inventory for Respiratory Disease (AIR) scale and the Hospital Anxiety and Depression Scale (HADS). The St. George\u2019s Respiratory Questionnaire (SGRQ) was used to assess HRQOL. Based on their anxiety levels, the patients were divided into a no anxiety group and a high anxiety group. There were no significant differences between the two groups in terms of pulmonary function profile or smoking status. The mean AIR and HADS (depression) scores were high (12.78 \u00b1 4.07 and 9.90 \u00b1 3.41, respectively). More than one-third of the patients (46%) reported high anxiety levels (above the standard cutoff score of 8). The mean score of the aggregated HADS scale was significantly higher in the high anxiety group (20.87 \u00b1 6.13) than in the no anxiety group (9.26 \u00b1 4.72; p = 0.01). Patients with high anxiety had poorer functional performance (6MWT: 308.75 \u00b1 120.16 m) and HRQOL (SGRQ: 56.54 \u00b1 22.36) than patients with no anxiety (6MWT: 373.76 \u00b1 106.56 m; SGRQ: 42.90 \u00b1 24.76; p &lt; 0.01). The final multivariate model explained 33% of the variance in functional performance after controlling for COPD severity (F = 8.97). The results suggest that anxiety, depression, and poor health status are significantly associated with poor functional performance. This study highlights the need to screen patients with COPD at all stages for anxiety and depression.<\/jats:p>","DOI":"10.3390\/ijerph20021285","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T01:33:12Z","timestamp":1673400792000},"page":"1285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Impact of Psychological Factors on Functional Performance among Patients with Chronic Obstructive Pulmonary Disease"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5255-4860","authenticated-orcid":false,"given":"Monira I.","family":"Aldhahi","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3072-7123","authenticated-orcid":false,"given":"Baian A.","family":"Baattaiah","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8845-109X","authenticated-orcid":false,"given":"Rakan I.","family":"Nazer","sequence":"additional","affiliation":[{"name":"Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0554-8721","authenticated-orcid":false,"given":"Ali","family":"Albarrati","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1378\/chest.08-1419","article-title":"COPD as a Disease of Accelerated Lung Aging","volume":"135","author":"Ito","year":"2009","journal-title":"Chest"},{"key":"ref_2","first-page":"1205","article-title":"Surprisingly High Prevalence of Anxiety and Depression in Chronic Breathing Disorders","volume":"127","author":"Kunik","year":"2005","journal-title":"Chest"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1136\/thx.2009.126201","article-title":"Influence of Anxiety on Health Outcomes in COPD","volume":"65","author":"Eisner","year":"2010","journal-title":"Thorax"},{"key":"ref_4","first-page":"1287","article-title":"Depression Symptoms Reduce Physical Activity in COPD Patients: A Prospective Multicenter Study","volume":"11","author":"Demeyer","year":"2016","journal-title":"Int. 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