{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:55:05Z","timestamp":1788555305429,"version":"build-2803163510"},"reference-count":45,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Bialystok","award":["B.SUB.25.130"],"award-info":[{"award-number":["B.SUB.25.130"]}]},{"award":["B.SUB.25.130"],"award-info":[{"award-number":["B.SUB.25.130"]}],"id":[{"id":"https:\/\/ror.org\/00y4ya841","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Chronic obstructive pulmonary disease (COPD) is associated with substantial symptom burden and functional limitations, which may co-occur with psychological distress. This pilot study aimed to assess depressive symptoms, anxiety, insomnia, and sexual quality of life in patients with COPD living in the Podlaskie Voivodeship. Materials and Methods: This cross-sectional pilot study included 47 patients with COPD, including outpatients (n = 11) and inpatients (n = 36), recruited at the University Teaching Hospital in Bialystok between February and August 2025. The original survey questionnaire, Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), Generalized Anxiety Disorder-7 (GAD-7), Athens Insomnia Scale (AIS), Insomnia Severity Index (ISI), and Sexual Quality of Life (SQoL) questionnaires were used. Results: In the study sample, median scores indicated a considerable burden of depressive symptoms (BDI Me = 16), anxiety (HAM-A Me = 27; GAD-7 Me = 15), and insomnia (AIS Me = 9; ISI Me = 14), alongside reduced sexual quality of life (SQoL Me = 46). Age in the total sample correlated positively with depressive symptoms, anxiety, and sleep difficulties, and negatively with SQoL; however, these relationships were not consistently maintained in age-stratified analyses. Crude inpatient\u2013outpatient differences were substantial, but supplementary adjusted models showed that subjective symptom severity was the most consistent predictor across outcomes, whereas the independent role of hospitalization status was attenuated. Strong associations were observed between depression, anxiety, insomnia, and sexual quality of life. Conclusions: This pilot study indicates a substantial within-sample psychological burden in patients with COPD and suggests that these outcomes are closely associated with subjective symptom burden. Given the small sample size, marked group imbalance, cross-sectional design, and lack of objective COPD severity measures, the findings should be interpreted as exploratory and require confirmation in larger multicenter studies.<\/jats:p>","DOI":"10.3390\/jcm15072769","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:09:00Z","timestamp":1775549340000},"page":"2769","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Depressive Symptoms, Anxiety, Insomnia, and Sexual Quality of Life in Patients with Chronic Obstructive Pulmonary Disease from the Podlaskie Voivodeship, Poland: A Cross-Sectional Pilot Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Katarzyna","family":"Bojarska","sequence":"first","affiliation":[{"name":"Department of Integrated Medical Care, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda","family":"Orzechowska","sequence":"additional","affiliation":[{"name":"Department of Integrated Medical Care, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Grochowski","sequence":"additional","affiliation":[{"name":"Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Skiepko","sequence":"additional","affiliation":[{"name":"Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5116-3497","authenticated-orcid":false,"given":"Mateusz","family":"Cybulski","sequence":"additional","affiliation":[{"name":"Department of Integrated Medical Care, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"ref_1","unstructured":"(2025, December 30). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease: 2024 Report. Available online: https:\/\/goldcopd.org."},{"key":"ref_2","unstructured":"(2025, December 30). Chronic Obstructive Pulmonary Disease (COPD). Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-(copd)."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1016\/S0140-6736(12)61728-0","article-title":"Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Lozano","year":"2012","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1183\/09059180.00007813","article-title":"Depression and anxiety in patients with COPD","volume":"23","author":"Yohannes","year":"2014","journal-title":"Eur. Respir. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1183\/09031936.00084408","article-title":"COPD in Chinese nonsmokers","volume":"33","author":"Zhou","year":"2009","journal-title":"Eur. Respir. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1016\/j.rmed.2006.01.026","article-title":"Anxiety and depression in COPD patients: The roles of gender and disease severity","volume":"100","author":"Verga","year":"2006","journal-title":"Respir. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.rmed.2004.11.017","article-title":"Sleep quality, daytime sleepiness and fasting insulin levels in women with chronic obstructive pulmonary disease","volume":"99","author":"Saaresranta","year":"2005","journal-title":"Respir. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1111\/j.1440-1843.2012.02148.x","article-title":"Treatments for anxiety and depression in patients with chronic obstructive pulmonary disease: A literature review","volume":"17","author":"Cafarella","year":"2012","journal-title":"Respirology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jpsychires.2014.02.023","article-title":"Chronic Obstructive Pulmonary Disease and its association with sleep and mental disorders in the general population","volume":"54","author":"Ohayon","year":"2014","journal-title":"J. Psychiatr. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"zsy044","DOI":"10.1093\/sleep\/zsy044","article-title":"Sleep disruption as a predictor of quality of life among patients in the subpopulations and intermediate outcome measures in COPD study (SPIROMICS)","volume":"41","author":"Zeidler","year":"2018","journal-title":"Sleep"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"20252","DOI":"10.1038\/s41598-019-56440-9","article-title":"Association between medicated obstructive pulmonary disease, depression and subjective health: Results from the population-based Gutenberg Health Study","volume":"9","author":"Wiltink","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1378\/chest.12-1911","article-title":"Bidirectional associations between clinically relevant depression or anxiety and COPD: A systematic review and meta-analysis","volume":"144","author":"Atlantis","year":"2013","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.hrtlng.2008.02.005","article-title":"Chronic obstructive pulmonary disease, anxiety, and depression: State of the science","volume":"38","author":"McCrone","year":"2009","journal-title":"Heart Lung"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"297","DOI":"10.2147\/COPD.S347578","article-title":"Sexual health in COPD: A systematic review and meta-analysis","volume":"17","author":"Frederiksen","year":"2022","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"ref_15","first-page":"215","article-title":"Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD)","volume":"2","author":"Steier","year":"2010","journal-title":"J. Thorac. Dis."},{"key":"ref_16","first-page":"328","article-title":"Decreased Cardiac Autonomic Function is Associated with Higher Exacerbation Risk and Symptom Burden in Chronic Obstructive Pulmonary Disease","volume":"10","author":"Raju","year":"2023","journal-title":"Chronic Obstr. Pulm. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Llewellyn-Smith, I.J., and Verberne, A.J.M. (2011). Autonomic Regulation of Sexual Function. Central Regulation of Autonomic Functions, Oxford University Press. [2nd ed.].","DOI":"10.1093\/acprof:oso\/9780195306637.001.0001"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/2049-6958-8-66","article-title":"Erectile dysfunction and sex hormone changes in chronic obstructive pulmonary disease patients","volume":"8","author":"Kahraman","year":"2013","journal-title":"Multidiscip. Respir. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1742-1241.2007.01501.x","article-title":"Sex hormone alterations and systemic inflammation in chronic obstructive pulmonary disease","volume":"63","author":"Karadag","year":"2009","journal-title":"Int. J. Clin. Pract."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S0954-6111(05)80062-9","article-title":"Testosterone levels during systemic and inhaled corticosteroid therapy","volume":"88","author":"Morrison","year":"1994","journal-title":"Respir. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1001\/archpsyc.1961.01710120031004","article-title":"An inventory for measuring depression","volume":"4","author":"Beck","year":"1961","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Beck, A.T., Steer, R.A., and Brown, G.K. (1996). Manual for the Beck Depression Inventory-II, Psychological Corporation.","DOI":"10.1037\/t00742-000"},{"key":"ref_23","first-page":"71","article-title":"Psychometric properties of the polish version of the Aaron T. Beck\u2019s Depression Inventory BDI-II","volume":"19","author":"Zawadzki","year":"2009","journal-title":"Psychol. Etol. Genet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.2044-8341.1959.tb00467.x","article-title":"The assessment of anxiety states by rating","volume":"32","author":"Hamilton","year":"1959","journal-title":"Br. J. Med. Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/0165-0327(88)90072-9","article-title":"The Hamilton Anxiety Scale: Reliability, validity and sensitivity to change","volume":"14","author":"Maier","year":"1988","journal-title":"J. Affect. Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"493","DOI":"10.13075\/ijomeh.1896.02104","article-title":"Psychometric properties of the Polish version of the Generalized Anxiety Disorder Scale (GAD-7) in a non-clinical sample of employees during pandemic crisis","volume":"36","year":"2023","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/S0022-3999(00)00095-7","article-title":"Athens Insomnia Scale: Validation of an instrument based on ICD-10 criteria","volume":"48","author":"Soldatos","year":"2000","journal-title":"J. Psychosom. Res."},{"key":"ref_29","first-page":"211","article-title":"Validation of the Polish version of the Athens Insomnia Scale","volume":"45","author":"Szelenberger","year":"2011","journal-title":"Psychiatr. Pol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/sleep\/34.5.601","article-title":"The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response","volume":"34","author":"Morin","year":"2011","journal-title":"Sleep"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/00926230591006502","article-title":"Development of a questionnaire on sexual quality of life in women","volume":"31","author":"Symonds","year":"2005","journal-title":"J. Sex. Marital Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1111\/j.1743-6109.2007.00749.x","article-title":"Psychometric validation of a sexual quality of life questionnaire for use in men with premature ejaculation or erectile dysfunction","volume":"5","author":"Abraham","year":"2008","journal-title":"J. Sex. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1016\/j.rmed.2013.06.002","article-title":"Functional and psychological variables both affect daily physical activity in COPD: A structural equations model","volume":"107","author":"Altenburg","year":"2013","journal-title":"Respir. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/1465-9921-14-53","article-title":"Systemic inflammation, depression and obstructive pulmonary function: A population-based study","volume":"14","author":"Lu","year":"2013","journal-title":"Respir. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"259","DOI":"10.5664\/jcsm.4540","article-title":"Sleep disorders in chronic obstructive pulmonary disease: Etiology, impact, and management","volume":"11","author":"Budhiraja","year":"2015","journal-title":"J. Clin. Sleep Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.sleep.2011.12.007","article-title":"Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes","volume":"13","author":"Omachi","year":"2012","journal-title":"Sleep Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1164\/rccm.200903-0347PP","article-title":"Chronic obstructive pulmonary disease and obstructive sleep apnea: Overlaps in pathophysiology, systemic inflammation, and cardiovascular disease","volume":"180","author":"McNicholas","year":"2009","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1164\/rccm.200912-1869OC","article-title":"Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: The overlap syndrome","volume":"182","author":"Marin","year":"2010","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"501","DOI":"10.2147\/COPD.S58136","article-title":"Depression and anxiety predict health-related quality of life in chronic obstructive pulmonary disease: Systematic review and meta-analysis","volume":"9","author":"Blakemore","year":"2014","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s12931-020-01572-0","article-title":"COPD burden on sexual well-being","volume":"21","author":"Zysman","year":"2020","journal-title":"Respir. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.rmed.2007.09.012","article-title":"Sexuality in patients with asthma and COPD","volume":"102","author":"Kaptein","year":"2008","journal-title":"Respir. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"14799731211020322","DOI":"10.1177\/14799731211020322","article-title":"Sexual health communication in COPD: The role, contents and design of patient information leaflets","volume":"18","author":"Hilberg","year":"2021","journal-title":"Chron. Respir. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.maturitas.2022.01.014","article-title":"Patients with chronic diseases: Is sexual health brought up by general practitioners during appointments? A web-based study","volume":"160","author":"Manninen","year":"2022","journal-title":"Maturitas"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1080\/08039480310000824","article-title":"Anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). A review","volume":"58","author":"Mikkelsen","year":"2004","journal-title":"Nord. J. Psychiatry"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/7\/2769\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T04:14:28Z","timestamp":1775621668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/7\/2769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":45,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["jcm15072769"],"URL":"https:\/\/doi.org\/10.3390\/jcm15072769","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]}}}