Psychological issues, particularly anxiety and depression, have received growing attention in chronic disease patients and should not be overlooked when assessing patient’s quality of life (QoL). This is an important target in the clinical management of a chronic irreversible diseases, such as chronic obstructive pulmonary disease (COPD) A case control study of include 100 patients with advanced chronic respiratory diseases including severe persistent asthma, severe COPD, extensive bronchiectasis and interstitial lung diseases. Patients were selected randomly from those attending inpatient ward and outpatient clinic at Chest department in Benha University Hospitals. 20 age and sex matched apparently normal subjects will be also included as negative controls as well as 20 mild chronic respiratory disorders as positive controls.There was high significant FEV1 was in negative control than positive control than the studied group, Anxiety and depression more in female than males .Also absence of anxiety was significantly high in negative control than in positive control than in study group. highly significant depression scores in the study groups than control group. the Prevalence of anxiety and depression more in patients without respiratory failure than those have respiratory failure.Prevalence of anxiety and depression more common in chronic respiratory diseases.Many factors affect prevalence and severity of both anxiety and depression as gender,FEV1, PAP, dyspnea.