COPD and the Risk of Depression

Schneider, Cornelia; Jick, Susan S.; Bothner, Ulrich; Meier, Christoph

doi:10.1378/chest.09-0614

Cited by 176 publications

(153 citation statements)

References 28 publications

Supporting

Mentioning

131

Contrasting

Unclassified

Order By: Relevance

“…The independence of depression from COPD is further supported by the fact that 23% of these patients had already experienced depressive episodes before the onset of COPD [65]. This reasoning underlines that caution is required when interpreting depression mainly as an understandable reaction to COPD, even when the patients themselves name COPD as the reason for their despair.…”

Section: Practical Consequencesmentioning

confidence: 85%

Depression and suicidality in COPD: understandable reaction or independent disorders?

Hegerl

Mergl

2014

European Respiratory Journal

View full text Add to dashboard Cite

Both depression and chronic obstructive pulmonary disease (COPD) are prevalent, severe and often comorbid disorders. There is a risk of undertreatment for depression in patients with COPD as depressive symptoms, including suicidal tendencies, can erroneously be conceptualised as an understandable reaction to COPD and not as signs of an independent depressive disorder. In this context, the comorbidity rates of COPD and depression, the risk of suicidal behaviour in patients with COPD, and the evidence base for pharmaco-and psychotherapy in these patients are reviewed.Because symptoms of depression and COPD overlap it remains unclear how far the prevalence of major depression in COPD exceeds that in the general population. The suicide risk appears to be increased in COPD. Methodological studies providing evidence for the antidepressant efficacy of antidepressants or psychotherapy in patients with COPD are lacking. Recommendations for clinicians on how to separate depression from an understandable reaction to COPD are provided.Given the profound effects of depression on quality of life, life expectancy, COPD prognosis and suicide risk it is important to carefully diagnose and treat depression in patients with COPD according to national guidelines. @ERSpublications Comorbid depression has profound effects on COPD prognosis and should not be seen as understandable reaction to COPD

show abstract

Section: Practical Consequencesmentioning

confidence: 85%

Depression and suicidality in COPD: understandable reaction or independent disorders?

Hegerl

Mergl

2014

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…6 Nearly 20% of patients had episodes of moderate to severe depression prior to their COPD diagnosis. 7 Anxiety disorders, which have considerable overlap and clinical outcomes. Therefore, the purpose of this cross-sectional study was to determine the association between depression and anxiety with accelerometrybased, free-living, ambulatory PA in patients with COPD.…”

mentioning

confidence: 99%

Patients With COPD With Higher Levels of Anxiety Are More Physically Active

Nguyen

Fan

Herting

et al. 2013

Chest

View full text Add to dashboard Cite

Epidemiologic studies based on self-reported physical activity (PA) show that higher levels of activ ity are associated with lower risk of incident COPD in smokers and in patients who already have COPD, and with lower risk of acute exacerbations, hospital admissions, and mortality. 1-3 A recent, 4-year, prospective study of patients with COPD showed that objectively measured PA was the best predictor of all-cause mortality compared with a broad range of other prognostic factors, including airfl ow obstruction, exercise performance, cardiovascular status, nutritional and muscular status, systemic infl ammation, health status, depressive symptoms, and dyspnea. Each increase of 1,845 steps per day was associated with a 51% lower risk of death. 4 Objective measures of PA capture what patients actually do vs what they report doing or are capable of doing during a laboratory test. 5 Findings from these studies underscore the critical importance of PA in COPD and the need to better understand how modifi able factors such as psychologic well-being infl uence PA.The prevalence of major depression in patients with moderate to severe COPD is approximately 40%. 6 Nearly 20% of patients had episodes of moderate to severe depression prior to their COPD diagnosis. 7 Anxiety disorders, which have considerable overlap Background: Physical activity (PA) has been found to be an excellent predictor of mortality beyond traditional measures in COPD. We aimed to determine the association between depression and anxiety with accelerometry-based PA in patients with COPD. Methods: We performed a cross-sectional analysis of baseline data from 148 stable patients with COPD enrolled in an ongoing, longitudinal, observational study. We measured PA (total daily step count) with a Stepwatch Activity Monitor over 7 days, depression and anxiety with the Hospital Anxiety and Depression Scales (HADSs), dyspnea with the Shortness of Breath Questionnaire, and functional capacity with the 6-min walk test. Results: Increased anxiety was associated with higher levels of PA such that for every one-point increase in the HADS-Anxiety score there was a corresponding increase of 288 step counts per day ( b 5 288 steps, P , .001), after adjusting for all other variables. Higher levels of depressive symptoms were associated with lower PA ( b 5 2 176 steps, P 5 .02) only when anxiety was in the model. The interaction term for anxiety and depression approached signifi cance ( b 5 26, P 5 .10), suggesting that higher levels of anxiety mitigate the negative effects of depression on PA. Conclusions:The increased PA associated with anxiety in COPD is, to our knowledge, a novel fi nding. However, it is unclear whether anxious patients with COPD are more restless, and use increased psychomotor activity as a coping mechanism, or whether those with COPD who push themselves to be more physically active experience more anxiety symptoms. Future studies should evaluate for anxiety and PA to better inform how to improve clinical outcomes.

show abstract

“…15 A recent longitudinal study by Schnider, 35722 COPD patients and the same number without COPD were followed up for ten years the incidence of depression was 16.2 cases per 1000 (person-years) in COPD group and same was 9.4/1000 (person-years) in control group, OR: 2.01; 95%CI, 1.45-2.78. 16 Mean HAM-D score of the patients enrolled in the present study was 7.04. In the current study 13 males and 6 females had HAM-D score pointing towards depression.…”

Section: Discussionmentioning

confidence: 62%

Depression and COPD-association: not out of the blue

Ali

Salve

2017

Int J Res Med Sci

View full text Add to dashboard Cite

Background: Depression is frequently associated with C.O.P.D. patients. Currently available treatment modalities are having limitations and chronic progression of the disease process in general causes decreased effort tolerance and poor socialization due to chronic cough and dyspnoea. Poor socialization and chronic symptoms result in mild depression to dysthymia and clinical depression. Three or more comorbidities associated with C.O.P.D. results in higher morbidity and mortality. Physician treating C.P.O.D. patients can use simple questionnaire based Hamilton depression scale to identify the patients having depressive symptoms.Methods: 50 diagnosed COPD patients as per GOLD guidelines were enrolled in the study after consideration of inclusion and exclusion criteria. Each patient was screened for depression using 17-point Hamilton depression scale. The results were tabulated and analyzed for statistical significance and compared with the data available on this topic.Results: Out of 50 stable COPD (diagnosed as per GOLD guidelines) patients enrolled for the study, 36 (72%) were males and 14 (28%) were females and in 19 (38%), (15 males and 4 females) patients HAM-D score was suggestive of depression. 10 (62.5%) patients from severe obstruction category (GOLD III) had mild depressive symptoms on HAM-D scale.Conclusions: Considering the fact that a significant number of COPD patients enrolled for the study had depressive symptoms, it is advisable to screen the patients for depression and psychiatrist consultations should be considered when required.

show abstract

COPD and the Risk of Depression

Cited by 176 publications

References 28 publications

Depression and suicidality in COPD: understandable reaction or independent disorders?

Depression and suicidality in COPD: understandable reaction or independent disorders?

Patients With COPD With Higher Levels of Anxiety Are More Physically Active

Depression and COPD-association: not out of the blue

Contact Info

Product

Resources

About