Depression Common, Worsens Exacerbations in COPD Patients

Two recent studies published in CHEST investigated the impact of depression on patients with chronic obstructive pulmonary disease (COPD). Little previous research has explored this association.

In the first study, the researchers assessed 3-year data from 1589 patients with COPD who were participating in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints study.
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Patients were separated into 4 groups based on Center for Epidemiologic Studies Depression Scale score (less than 16 or ≥16) and antidepressant use (yes or no).

Of the 1589 participants with COPD who completed 3-year follow-up, 55% were never depressed, 24% were persistently depressed, 14% developed new onset of depression, and 7% had depression that remitted.

Those with persistent or new onset of depression reported more exacerbations and more significant loss in performance, demonstrated by reduction in 6-minute walk distance.

“About 1 in 4 patients with COPD had persistent depressive symptoms over 3 years,” the researchers concluded. “Clinicians should be aware of the characteristics of persistent and new onset depressive symptoms, which are associated with risk of exacerbations and loss of performance on the [6-minute walk distance] test. Interventions that ameliorate the course of depression are needed.”¹

In the second study, to determine whether psychological disorders were associated with an increased risk of 30-day readmission rates, the researchers analyzed data from fee-for-service Medicare beneficiaries diagnosed with COPD between 2001 and 2011 who were hospitalized for COPD or respiratory failure with COPD.

Of the 80,088 patients assessed, 22.3% had one or more psychological disorders.

The researchers found that the 30-day admission rates were higher in patients with COPD who also had depression, anxiety, and psychosis and who abused alcohol or drugs compared with those who did not have psychological disorders.

“Psychological disorders like depression, anxiety, psychosis, alcohol abuse, and drug abuse are independently associated with higher all-cause 30-day readmission rates for Medicare beneficiaries with COPD,” the researchers concluded.²

—Amanda Balbi

References:

1. Yohannes AM, Müllerová H, Hanania NA, et al. Long-term course of depression trajectories in patients with COPD: a 3-year follow-up analysis of the evaluation of COPD longitudinally to identify predictive surrogate endpoints cohort. Chest. 2016;149(4):916-926. doi:10.1016/j.chest.2015.10.081.
2. Singh G, Zhang W, Kuo YF, Sharma G. Association of psychological disorders with 30-day readmission rates in patients with COPD. Chest. 2016;149(4):905-915. doi: 10.1378/chest.15-0449.