Depression in copd: risk determinants and health related quality of life (HRQoL)

Background & Objectives: Presence of two comorbidities, both chronic obstructive pulmonary disease (COPD) and depression impacts significantly on the morbidity and mortality of patients and thus interfering with quality of life and disease management. Indian studies throw limited light and data regarding identification of risk factors for depressive symptoms in patients with COPD and its impact on quality of life. This study was undertaken to identify the prevalence of depression and risk determinants of COPD patients attending a tertiary care health facility in north India. Materials & Methods: COPD was classified according to GOLD stages based on forced expiratory volume in one second (FEV1) in 85 stable patients. Depression was examined by administering HAM-D (Hamilton depression) Scale. Linear regression model was used to examine association between predictor variables of COPD and depression with adjustment of age, sex and smoking status. Results: In the study population as whole 51.76%, patients showed depressive symptoms. Higher depression scores 12.35 ± 9.18 was present in moderate to severe COPD. Depression was found to be higher among patients with higher CAT Score, SGRQ_S Score, SGRQ_I Score and SF-36-MCS scale (HRQoL) Score. Activity components of SGRQ (SGRQ_A Score) were found to be potential predictors of depression in COPD patients. Interpretation & Conclusions: Majority of COPD patients have severe symptoms related to depression with increasing severity of COPD. Hence, clinicians and the patients both should be focused in adequate and timely management of both these comorbidities. Future studies are needed to adequately identify the casual association and management of both these conditions.