Comorbidity of Depression on Exacerbation COPD Patients

Objectives: Depression is frequent in patients with COPD and increase as the severity of disease progresses. Depression affect quality of life and functioning over and above what would be expected given the severity of their COPD disease. The aim of our study was to assess the prevalence of comorbidity of depression on exacerbation COPD patients and correlation with the severity of COPD.
 

Methods: There is a prospective observational study conducted on Regional Hospital Fier. Are enrolled 51patients with COPD; 84.3% male; mean age, 70±9.4 years; smokers - 9(17,6%), ex smokers - 32(62,7%); comorbidities – 33(64.7%). The presence of Depression was assessed using the Hospital Anxiety and Depression scale (HADS). The COPD Assessment Test (CAT) was used to evaluate quality of life. The BODE and COTE (COPD specific comorbidity test) indexes were also calculated. The clinical parameters included were dyspnoea measured by the modified Medical Research Council scale (mMRC), six minutes walking test (6MWT), exacerbations and body mass index (BMI).
 

Results: The prevalence of Depression (Scoring: 11-21 according to the HADS) resulted in 23(45.1%) patients, and 15(29.4%) patients are classified as borderline cases (Scoring: 8-10). Of COPD patients with depression, only 4 (17.4%) were receiving treatment for depression. In total COPD cases, those with concomitant depression, and those without depression, respectively, the average age resulted 70±9.4, 73.96±8.23, 66.8±9.2; male gender: 43(84.3%),18 (78.3%),25(89.3%); female gender: 8(15.7%), 5(21.7%), 3(10.7%); other concomitant diseases: 33(64.7%), 19 (82.6%), 14(50%). The average number/year for acute exacerbations resulted in COPD cases 1.92±0.95, those with concomitant depression 2.04±0.97, and those with no depression 1.82±0.94, while the average hospitalizations were1.16±0.73, 1.26±0.81, and 1.07±0.66, respectively. The presence of depression was significantly associated with severity of COPD stage- 0.293*; CAT test- 0.507**; BODE index- 0.377**; MRC dyspnoea scale- 0.543**; 6MWT- 0.476** [**. Correlations significant at the 0.01 level (2-tailed), *. Correlations significant at the 0.05 level (2-tailed)]
 

Conclusion: Prevalence of Depression in patients with COPD correlate with the severity of the diseases, and are often overlooked, undiagnosed and rarely treated. Patients with COPD and Depression more frequently suffer acute exacerbations, hospitalizations, and are associated with more concomitant diseases.