COPD patients who have moderate to severe depression may be at increased risk for death…
According to findings from a study published in the March issue of Chest, individuals with stabilized chronic obstructive pulmonary disease (COPD) who have moderate to severe depression are at an increased risk for death. According to the study, upon follow up with stable COPD patients with depression researchers found that they possessed nearly twice the likelihood of death from any cause. Those patients with uncontrolled COPD and moderate to severe depression were also found to have an increased mortality rate. Researchers, commenting on the study’s findings, stated “…what is needed next is explication of both the determinants of depressive symptoms and of the pathway between these symptoms and mortality.” Future studies should examine whether alleviation of depressive symptoms results in a lessening mortality rate in this population. The following is an excerpt of an article from Medpage Today that discusses the study more:
Although depression increases the risk of death in patients with COPD during or shortly after an exacerbation, conflicting data have clouded the nature of same relationship in patients with stable disease, the researchers said.
To find out, the researchers monitored 121 patients (mean age 61.5) with stable COPD (mean forced expiratory volume in one second 36.9% of predicted). They were studied from hospital admission for pulmonary rehabilitation through follow-up lasting up to 8.5 years.
All patients were clinically stable for at least six weeks before entering the study.
Depressive symptoms were measured using the Beck Depression Inventory, a 21-item self-administered survey measuring attitudes and symptoms of depression. A score of at least 19 out of 63 was used to indicate the presence of depressive symptoms.
Nearly one in five patients (19.8%) met that threshold.
Through follow-up, 63% of the patients died. Overall median survival was 5.3 years.
In a multivariate analysis, depressive symptoms were associated with all-cause death (P<0.05), independent of gender, age, and exercise capacity.
Male sex (OR 1.73, 95% CI 1.03 to 2.92) and older age (OR 1.05, 95% CI 1.02 to 1.08) were associated with an increased risk of mortality, and better exercise capacity (OR 0.98, 95% CI 0.97 to 0.99) was associated with a slightly decreased risk.
There were two possible explanations for the link between depression and mortality in patients with COPD, according to the researchers.