Exacerbations Lead To Depression In COPD

Main Category: COPD
Also Included In: Depression
Article Date: 30 Jun 2008 - 2:00 PST

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Chronic obstructive pulmonary disease (COPD) causes limitation of airflow in the lungs that cannot be fully reversed, leading to symptoms of breathlessness, cough, wheeze and sputum production. The disease, although chronic, is interspersed with periods of acute symptomatic and functional deterioration known as exacerbations. Exacerbations have important consequences for patients and their healthcare providers.

It is not fully understood why some individuals with COPD are prone to frequent exacerbations (three or more per year), however, it is known that these individuals have worse quality of life, greater limitation of daily activity and faster disease progression than infrequent exacerbators (patients who have fewer than three exacerbations per year). Depression is a recognised complication of many chronic diseases, including COPD, and this also affects quality of life.

In this study, Jadwiga Wedzicha (Academic Unit of Respiratory Medicine, University College London, UK) and his colleagues prospectively investigated 169 patients over a one-year period and assessed whether depressive symptoms increased at the time of an exacerbation and whether depression was related to exacerbation frequency.

They find that depressive symptoms are significantly higher at exacerbation than at baseline. The authors also find that frequent exacerbators have significantly higher depression scores in the stable state compared to infrequent exacerbators.

Patients who are depressed have a poorer quality of life, increased breathlessness, spend less time outdoors, and are more likely to be female and live alone.

The British team concludes that lack of recognition of depression may have implications for uptake and completion of treatment, including pulmonary rehabilitation, and propose that frequent exacerbators should be screened routinely and treated for depression if appropriate. This may help maximise patient outcome and quality of life in COPD.

Title Of The Original Article
Relationship between depression and exacerbations in COPD

The European Respiratory Journal is the peer-reviewed scientific publication of the European Respiratory Society (more than 8,000 specialists in lung diseases and respiratory medicine in Europe, the United States and Australia).

European Respiratory Journal