Chronic Obstructive Pulmonary Disease and Risk of Incident Depression

A new study finds that Chronic Obstructive Pulmonary Disease (COPD) is associated with the risk of incident depression. Therefore, healthcare providers managing patients with COPD should stay alert about the existence of depression and be aware of its symptoms and consequences.

The study has been published in the journal Respiratory Medicine.

It is increasingly recognized that the presence of comorbidities plays a major role in COPD prognosis and greatly contributes to the severity of the disease. The reported prevalence of depression in COPD ranges from 15% to 36%, depending on the study population and methodological designs. However, there has been no updated work on the incidence rate of a new onset of depression following a diagnosis of COPD.

Depression is amongst the most common comorbidities in COPD, resulting in impaired quality of life, poor adherence to medication regimens and pulmonary rehabilitation, increased risk of COPD exacerbation, and greater mortality.

This study hypothesized that the incidence of depression or antidepressant prescription in patients with COPD would be greater than in subjects without COPD. This study conducted by R.A. Siraj et al. tried to determine the incidence of newly diagnosed depression or new antidepressant prescription following a diagnosis of COPD and compare this to subjects without COPD using a large primary care database. However, there is little information available on the incidence of depression following a COPD diagnosis.

A matched cohort study was conducted using The Health Improvement Network database. Patients with confirmed COPD diagnosis were matched to up to four subjects without a COPD diagnosis by age, sex, and GP practice. Cox proportional hazards models were used to assess the incidence rates of depression and antidepressant prescription. 44,362 patients with COPD and 124,140 subjects without COPD were included.

Results

• The incidence rate of depression per 1000 person-years following COPD diagnosis was greater compared to subjects without COPD.
• Patients with COPD were 42% more likely to have an incident depression and 40% more likely to be prescribed an antidepressant.
• The incidence of either depression or antidepressant prescription was also greater for patients with COPD.
• Patients with COPD and worse breathlessness had a higher risk of incident depression compared to patients with less breathlessness.

"As expected, this study found that patients with COPD from lower socioeconomic status were at increased risk of depression compared to those in the higher class; consistent with previous reports linking low socioeconomic status to increased prevalence of COPD, depression, and adverse health outcomes. Patients living in more deprived areas are likely to be exposed to several life stressors and have poor health care access, ultimately to the detriment of the patient. Taken together, the findings of this study suggest that healthcare systems should understand the impact of social disadvantage and be determined to provide equity when addressing issues in patients with COPD," the authors concluded.

For the full article: https://doi.org/10.1016/j.rmed.2022.106804