Depression is a common and chronic comorbidity in patients with interstitial lung disease

Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, California, USA.
Respirology (Impact Factor: 3.35). 12/2011; 17(3):525-32. DOI: 10.1111/j.1440-1843.2011.02122.x
Source: PubMed


Little is known about depression in interstitial lung disease (ILD). The aim of this study was to determine the prevalence of depression, characterize the association of depression with clinical variables and describe the natural history of depression in patients with ILD.
In this prospective cohort study, clinical variables were recorded at baseline and 6 months. Depression was measured with the Centre for Epidemiologic Studies Depression scale. Depression prevalence was determined using the established threshold of >15 points. Multivariate linear regression was used to determine the baseline features that independently correlated with baseline depression score and that predicted depression severity at follow-up.
Fifty-two subjects were enrolled, and 45 returned for follow-up (three deaths, one lung transplant). Prevalence of depression was 21% at baseline. Independent predictors of depressive symptoms at baseline included dyspnoea severity, pain severity, sleep quality and forced vital capacity (R(2) 0.67). The odds of clinically meaningful depression at follow-up were 34-fold higher for subjects who had clinically meaningful depression at baseline compared with those who were not (95% confidence interval 3.5-422, P < 0.0005). Baseline depression score was the strongest predictor of depression score at follow-up (r 0.59, P < 0.00005).
Depressive symptoms in ILD are common, persistent, and strongly and independently correlated with dyspnoea, pain, sleep quality and forced vital capacity. Clinically meaningful depression at baseline is the most important predictor of depressive symptoms at follow-up. Patients with ILD should routinely be screened for depression.

Download full-text


Available from: Virginia Carrieri-Kohlman, Oct 28, 2014
35 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The study aimed to assess psychiatric morbidity in stable chronic respiratory disorders and to examine the pattern of psychiatric illness in specific respiratory disorders in Northern India. Methods: All consecutive patients with stable chronic respiratory illnesses who attended the respiratory disease clinic were recruited in the study. Their healthy attendants were interviewed as a control group. The research clinician, trained in the use of the Global Mental Health Assessment Tool, Primary Care Version (GMHAT/PC), interviewed all the participants. The respiratory consultant made the respiratory illness diagnosis. The data were analyzed comparing the patient and the control group by using relative risk and adjusted odds ratios. Results: Of 391 patients with respiratory illness, 44.8% had a mental illness identified by GMHAT/PC interview compared with 24.3% of 177 attendants (controls). Anxiety (20.6%), depression (13.2%) and obsessive compulsive disorders (4.6%) were the most frequently identified mental disorders in the respiratory disease group. Chronic obstructive pulmonary disease and bronchial asthma when combined with rhinitis had a significantly higher prevalence of comorbid mental illness than those illnesses alone. Conclusion: Patients with chronic respiratory illness have high mental health comorbidity. Physicians and practitioners can be trained to identify mental illness using computer-assisted tools such as GMHAT/PC (which is easy to use by clinicians and well accepted by patients). A holistic approach of providing care to such patients may improve their overall outcome and quality of life.
    General hospital psychiatry 10/2012; 35(1). DOI:10.1016/j.genhosppsych.2012.09.009 · 2.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The care of patients with idiopathic pulmonary fibrosis is challenging at a time when there are no medications with proven efficacy in extending patient survival or quality of life. However, a number of recent studies suggest that patients participating in clinical trials including the placebo arm have improved outcome. This suggests that there are elements of supportive care which may prove beneficial to IPF patients. Further, control of patient symptoms should be a critical goal in care of patients with IPF. A number of both pharmacologic and nonpharmacologic therapies are available to reduce symptoms in patients with IPF. These include low-dose narcotics, pulmonary rehabilitation and oxygen therapy. Further, addressing issues of depression may be beneficial for symptom management. Palliative care can and should be more fully integrated in the care of patients with IPF. Incorporating supportive and palliative measures in the care of patients with IPF may improve both quality of life and survival, but far more research is needed in this fledgling field.
    Current opinion in pulmonary medicine 07/2013; 19(5). DOI:10.1097/MCP.0b013e328363f4cb · 2.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess depressive symptoms severity and dispositional optimism in patients with recent onset arthritis both before and after 4 months treatment. Two hundred twenty-two patients with recent onset RA and undifferentiated arthritis in the IMPROVED study filled out the Beck Depression Inventory (BDI-II) to assess depressive symptoms severity and the Life Orientation Test Revised (LOT-R) to measure optimism before and after 4 months of treatment. All patients were treated with methotrexate 25 mg/week and prednisone 60 mg/day (tapered to 7.5 mg/day in 7 weeks). Linear regression analysis was used to assess the association between the disease activity score (DAS) and its components (tender joint count, general well-being measured with a visual analogue scale (VAS), swollen joint count, and erythrocyte sedimentation rate) with the BDI-II an LOT-R scores. In general, depressive symptoms were mild. The DAS was an independent predictor of depressive symptoms scores both at baseline and after 4 months follow-up, in particular tender joint count and VAS global health. Disease activity was not associated with the level of optimism. Nevertheless, patients who achieved clinical remission improved significantly more in both depression score and optimism score than patients who did not. Patients with early arthritis report improvement in depressive symptoms and optimism with improvement in disease activity and achieving clinical remission. Depression scores are associated with pain and unwell being but not with swollen joint counts and inflammatory parameters.
    Clinical Rheumatology 07/2013; 32(12). DOI:10.1007/s10067-013-2337-9 · 1.77 Impact Factor
Show more