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Thorax. May 2002; 57(5): 412–416.
PMCID: PMC1746339

Risk of depression in patients with chronic obstructive pulmonary disease and its determinants

Abstract

Background: Although it has been repeatedly suggested that chronic obstructive pulmonary disease (COPD) is associated with depression, no conclusion has so far been reached. A study was undertaken to investigate whether depression occurs more often in patients with COPD than in controls. The demographic and clinical variables associated with depression were also determined.

Methods: Patients with a registered diagnosis of obstructive airway disease in general practice, aged ≥40 years, forced expiratory volume in 1 second (FEV1) <80% predicted, FEV1 reversibility ≤12%, FEV1/VC ≤ predicted – 1.64 x SD, and a history of smoking were selected. A random sample of subjects without a registered diagnosis of asthma or COPD aged 40 years or older acted as controls. Depression was assessed using the Centers for Epidemiologic Studies Depression (CES-D) scale.

Results: In patients with severe COPD (FEV1 <50% predicted), the prevalence of depression was 25.0% compared with 17.5% in controls and 19.6% in patients with mild to moderate COPD. When the results were adjusted for demographic variables and comorbidity, the risk for depression was 2.5 times greater for patients with severe COPD than for controls (OR 2.5, 95% CI 1.2 to 5.4). In patients with mild to moderate COPD this increased risk of depression was not seen. Living alone, reversibility of FEV1 % predicted, respiratory symptoms and physical impairment were significantly associated with the scores on the CES-D scale.

Conclusion: Patients with severe COPD are at increased risk of developing depression. The results of this study underscore the importance of reducing symptoms and improving physical functioning in patients with COPD.

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Selected References

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  • Curtis JR, Deyo RA, Hudson LD. Pulmonary rehabilitation in chronic respiratory insufficiency. 7. Health-related quality of life among patients with chronic obstructive pulmonary disease. Thorax. 1994 Feb;49(2):162–170. [PMC free article] [PubMed]
  • McSweeny AJ, Grant I, Heaton RK, Adams KM, Timms RM. Life quality of patients with chronic obstructive pulmonary disease. Arch Intern Med. 1982 Mar;142(3):473–478. [PubMed]
  • Prigatano GP, Wright EC, Levin D. Quality of life and its predictors in patients with mild hypoxemia and chronic obstructive pulmonary disease. Arch Intern Med. 1984 Aug;144(8):1613–1619. [PubMed]
  • Yohannes AM, Roomi J, Baldwin RC, Connolly MJ. Depression in elderly outpatients with disabling chronic obstructive pulmonary disease. Age Ageing. 1998 Mar;27(2):155–160. [PubMed]
  • Engström CP, Persson LO, Larsson S, Rydén A, Sullivan M. Functional status and well being in chronic obstructive pulmonary disease with regard to clinical parameters and smoking: a descriptive and comparative study. Thorax. 1996 Aug;51(8):825–830. [PMC free article] [PubMed]
  • Isoaho R, Keistinen T, Laippala P, Kivelä SL. Chronic obstructive pulmonary disease and symptoms related to depression in elderly persons. Psychol Rep. 1995 Feb;76(1):287–297. [PubMed]
  • van Ede L, Yzermans CJ, Brouwer HJ. Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review. Thorax. 1999 Aug;54(8):688–692. [PMC free article] [PubMed]
  • Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:5–40. [PubMed]
  • Siafakas NM, Vermeire P, Pride NB, Paoletti P, Gibson J, Howard P, Yernault JC, Decramer M, Higenbottam T, Postma DS, et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force. Eur Respir J. 1995 Aug;8(8):1398–1420. [PubMed]
  • Jones PW, Quirk FH, Baveystock CM. The St George's Respiratory Questionnaire. Respir Med. 1991 Sep;85 (Suppl B):25–37. [PubMed]
  • Light RW, Merrill EJ, Despars JA, Gordon GH, Mutalipassi LR. Prevalence of depression and anxiety in patients with COPD. Relationship to functional capacity. Chest. 1985 Jan;87(1):35–38. [PubMed]
  • Karajgi B, Rifkin A, Doddi S, Kolli R. The prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease. Am J Psychiatry. 1990 Feb;147(2):200–201. [PubMed]
  • Gordon GH, Michiels TM, Mahutte CK, Light RW. Effect of desipramine on control of ventilation and depression scores in patients with severe chronic obstructive pulmonary disease. Psychiatry Res. 1985 May;15(1):25–32. [PubMed]
  • Jones PW, Baveystock CM, Littlejohns P. Relationships between general health measured with the sickness impact profile and respiratory symptoms, physiological measures, and mood in patients with chronic airflow limitation. Am Rev Respir Dis. 1989 Dec;140(6):1538–1543. [PubMed]
  • Yellowlees PM. The treatment of psychiatric disorders in patients with chronic airways obstruction. Med J Aust. 1987 Oct 5;147(7):349–352. [PubMed]

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