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Association of Depression with Disease Severity in Patients with Chronic Obstructive Pulmonary Disease

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Abstract

Purpose

Patients with chronic obstructive pulmonary disease (COPD), which is predicted to be the third most common cause of death worldwide by 2020, often suffer from depression, one of the most common and modifiable comorbidities of COPD. This study assessed the prevalence of depression in patients with COPD and the association of depression with disease severity.

Methods

This was a multicenter, prospective cross-sectional study of 245 patients with stable COPD. Disease severity was assessed using two scales: the global initiative for chronic obstructive lung disease (GOLD) stage and BODE index. Depression was measured using the Centers for Epidemiologic Studies Depression (CES-D) scales. Data were analyzed using descriptive statistics, Spearman correlation, and multivariate logistic regression.

Results

Depression defined as a CES-D score of 24 and higher was observed in 17.6 % of patients with COPD. The prevalence of depression increased with disease severity based on the BODE quartile (r = 0.16; P = 0.014). By contrast, no difference was observed in the prevalence of depression among the severity groups using the GOLD staging system (r = − 0.01; P = 0.898). Elementary school graduates were more likely to experience depression than graduates of high school and above [odds ratio (OR) = 3.67; 95 % confidence interval (CI) 1.37–9.85] and patients in BODE quartile II were more likely to experience depression than those with BODE quartile I (OR = 2.5; 95 % CI  1.04–6.06).

Conclusions

Depression was associated with disease severity according to the BODE quartile in patients with COPD. BODE quartile II was a significant predictor of depression. Screening patients with a high risk of depression and proactive intervention for those patients are needed.

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Acknowledgments

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2009-0088833) and Pusan National University Research Grant, 2013.

Conflict of interest

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Authors and Affiliations

  1. Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Republic of Korea

    Ki Uk Kim, Hye-Kyung Park, Yun Seong Kim & Min Ki Lee

  2. Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

    Ki Uk Kim, Hye-Kyung Park, Yun Seong Kim & Min Ki Lee

  3. Department of Nursing, Pusan National University College of Nursing, Yangsan-si, Gyeongsangnam-do, Republic of Korea

    Hee Young Jung & Haejung Lee

  4. Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan, Republic of Korea

    Jong-Joon Ahn

  5. Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea

    Eunsoo Moon

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  1. Ki Uk Kim
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Correspondence to Hye-Kyung Park.

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Kim, K.U., Park, HK., Jung, H.Y. et al. Association of Depression with Disease Severity in Patients with Chronic Obstructive Pulmonary Disease. Lung 192, 243–249 (2014). https://doi.org/10.1007/s00408-013-9547-4

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  • DOI: https://doi.org/10.1007/s00408-013-9547-4

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