Relationship Between Depression in Patients With Chronic Obstructive Pulmonary Disease and the Percent Predicted FEV₁, BODE Index, and Health-Related QOL.

Abstract

OBJECTIVE: The prevalence of depression was investigated among patients with chronic obstructive pulmonary disease (COPD) treated in long-term inpatient rehabilitation facilities using the CES-D (Center for Epidemiologic Studies Depression Scale). Furthermore, the relationship between the severity of airflow obstruction (the percent predicted FEV₁), BODE (body mass index, degree of airflow obstruction, dyspnea, exercise capacity) index, health-related QOL (SGRQ: St. George's Respiratory Questionnaire) and depression were investigated. METHODS: 74 inpatients (64 males, 10 females) with COPD were recruited. The mean age of the subjects was 72.7 years (range 52-85 years). Subjects completed the CES-D and measurements were made of pulmonary function, BMI (body mass index), MMRC (the Modified Medical Research Council dyspnea scale), 6-minute walk test (6MWT), and SGRQ. RESULTS: Depression was evident in 48.6% (n=36) of the subjects. A weak correlation was found between the CES-D scores and the percent predicted FEV₁. The prevalence of depression showed a significant association with BODE stage. Scores for the Activity and Impacts domain, and Total SGRQ score were significantly worse in the subjects who were depressed. CONCLUSION: We found a high prevalence of depression among patients with stable COPD treated in long-term inpatient rehabilitation facilities. Depression among these patients, as measured by the CES-D, was associated with greater impairment in respiratory function and with poorer MMRC and SGRQ scores. Prevalence of depression increased with BODE stage.