Risk factors for depression in patients with chronic obstructive pulmonary disease

Hui-Ming Yao; Ren-Sen Xiao; Ping-Liang Cao; Xiao-Lei Wang; Wei Zuo; Wei Zhang

doi:10.5498/wjp.v10.i4.59

Risk factors for depression in patients with chronic obstructive pulmonary disease

World J Psychiatry. 2020 Apr 19;10(4):59-70. doi: 10.5498/wjp.v10.i4.59.

Authors

Hui-Ming Yao¹, Ren-Sen Xiao¹, Ping-Liang Cao², Xiao-Lei Wang², Wei Zuo¹, Wei Zhang³

Affiliations

¹ Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
² Second Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi Province, China.
³ Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China. weizhang1963@163.com.

Abstract

Background: The prevalence of depression in patients with chronic obstructive pulmonary disease (COPD) ranges from 10% to 42%, but the diagnosis of depression in patients with COPD is often unrecognized and untreated. Unrecognized depression has major implications for compliance with medical treatment, prolonged lengths of stay, increased frequency of hospital admissions, and increased consultations with primary care physicians. Many studies have attempted to identify risk factors for progression, prognosis and response to therapy in patients with depression. However, few studies have examined the risk factors for depression in patients with COPD, and some results remain controversial.

Aim: To identify the potential risk factors to define patients with COPD who are at "high risk" of depression.

Methods: The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018. The correlations between demographics, clinical characteristics and depression were analyzed. The risk factors for depression in patients with COPD were identiﬁed by multivariate logistic regression analysis. The cutoff value, sensitivity and speciﬁcity of the independent correlation factors were calculated with a receiver operating characteristic curve.

Results: Of the 293 patients included, 65 (22.18%) individuals were identiﬁed to have depression. Signiﬁcant differences were detected between patients with and without depression in terms of body mass index (BMI), forced expiratory volume in 1 s (FEV1), and COPD assessment test (CAT) score (all P < 0.05). Low BMI, low FEV1, and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI, FEV1, and CAT scores were 21.373 kg/m², 0.855 L and 12.5, respectively.

Conclusion: Low BMI, low FEV1, and high CAT score were identified as independent risk factors for depression in patients with COPD.

Keywords: Body mass index; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease assessment test scores; Depression; Forced expiratory volume in 1 second; Risk factors.