Severe depression raises odds for cough, wheezing, asthma, COPD

Key takeaways:

• Severe depression heightened a patient’s likelihood for cough, wheezing, exertional dyspnea, asthma and COPD.
• As depression grew in severity, more men vs. women experienced respiratory symptoms.

Patients with severe depression faced increased odds for cough, wheezing, exertional dyspnea, asthma and COPD vs. individuals without depression, according to results published in Respiratory Medicine.

“In this study, we found that the risk of respiratory symptoms increased with increasing depression scores and depression severity, not only that, major depression also increased the risk of asthma and COPD, and this correlation remained significant even after adjusting for variables,” Yuefeng Sun, of The First Clinical College at Shandong University of Traditional Chinese Medicine in China, and colleagues wrote.

In a national cross-sectional study, Sun and colleagues sought to determine how depression severity is linked to respiratory symptoms of cough, wheeze and exertional dyspnea as well as asthma and COPD through weighted logistic regression analysis.

The total cohort was made up of 10,142 adults (mean age, 59.7 years; 53.2% women) and reflected the U.S. population, researchers wrote.

Researchers used scores from the Patient Health Questionnaire 9 to determine depression severity; a high score (20-27) signaled severe depression, whereas a low score (0-4) signaled no depression.

Study findings

A model adjusted for age, sex, race/ethnicity, marital status, poverty income ratio, educational achievement, smoking status, BMI, cardiovascular disease, diabetes mellitus and hypertension showed that patients with severe depression had a 3.32 times (95% CI, 1.567-7.05) higher likelihood for cough vs. individuals without depression.

Individuals with severe depression also had elevated odds for wheeze (adjusted OR = 2.842; 95% CI, 1.521-5.311) and exertional dyspnea (aOR = 2.901; 95% CI, 1.518-5.544) when compared with individuals with no depression. Notably, patients with moderately severe depression had a heightened likelihood for exertional dyspnea (aOR = 3.233; 95% CI, 2.03-5.149), which was higher than the odds observed for those with severe depression.

The risk for asthma increased as depression became more severe, with the highest likelihood for asthma found among those with severe depression (aOR = 2.41; 95% CI, 1.371-4.236) vs. those with no depression.

Researchers found that the risk for COPD followed a similar pattern, and patients with severe depression faced the greatest odds for this outcome (aOR = 2.566; 95% CI, 1.236-4.921) compared with individuals without depression, closely followed by those with moderately severe depression (aOR = 2.546; 95% CI, 1.704-3.803).

Subgroup analyses

When the total cohort was divided according to gender, men with depression had significant increased odds for each of the three respiratory symptoms vs. men without depression (cough, OR = 3.21; 95% CI, 2.13-4.84; wheeze, OR = 2.66; 95% CI, 1.97-3.59; exertional dyspnea, OR = 2.78; 95% CI, 2-3.85).

Researchers further found that as depression grew in severity, more men vs. women experienced respiratory symptoms.

“Little research has been done on gender differences in the effects of depression on the respiratory system, and this will be the direction of our future research,” Sun and colleagues wrote.

In terms of race/ethnicity, researchers observed higher odds for cough with depression among Mexican Americans (OR = 2.76; 95% CI, 1.49-5.13) and non-Hispanic white individuals (OR = 2.44; 95% CI, 1.69-3.51) vs. other racial groups.

Separating the cohort based on smoking status revealed that current smokers with depression faced higher odds for asthma (OR = 1.77; 95% CI, 1.18-2.65) compared with former smokers and never smokers.

“This study further revealed the relationship between depression severity and the risk of respiratory symptoms, asthma and COPD,” Sun and colleagues wrote. “The effect of gender on the relationship between depression and respiratory symptoms was further found, and depression was an independent risk factor for the prevalence of asthma and COPD. This finding provides new insights into the management of respiratory symptoms and chronic respiratory diseases.”