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Reduced clinical performance may indicate depression in COPD patients

Patients with COPD in this study showed depressive symptoms during a 3-year follow-up period as characterized by reduced performance in clinical tests and increased exacerbations, according to recent research from the U.K.

“About one in four of COPD patients had persistent depressive symptoms over 3 years,” Abebaw Mengistu Yohannes, PhD, FCCP, of the physiotherapy department of health professions at Manchester Metropolitan University, Manchester, U.K., and colleagues wrote. “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. Interventions that ameliorate the course of depression are needed.”

Yohannes and colleagues evaluated 1,580 patients with COPD enrolled into the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Study, according to the abstract. Patients were divided into four groups based on whether their Centre for Epidemiologic Studies Depression Scale (CES-D) score was above or below 16 points and whether they used antidepressants (never depressed group, n = 869; persistently depressed, n = 368; new onset depression, n = 226; depression remission, n = 117).

The researchers found a significant association between persistent depression and female sex (OR = 2.95; 95% CI, 2.05-4.24) and stroke history (OR = 3.09; 95% CI, 1.43-6.67), according to the abstract. Factors for increased odds of new onset depression included worsening health status (OR = 1.10; 95% CI, 1.04-1.17; per 4-point increase in St. Georges Respiratory Questionnaire) and moderate-to-severe dyspnea (OR = 1.57; 95% CI, 1.07-2.31).

Yohannes and colleagues also noted reduced performance through a reduction in 6 minute walk distance as well as more exacerbations for patients with new onset depression and persistent depression during follow-up, according to the abstract. – by Jeff Craven

Disclosure: Two researchers report employment with GlaxoSmithKline and another researcher serves on the steering committee for ECLIPSE.