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Abstract
Objectives
Depression is commonly comorbid in the elderly patients with physical illness. This study examined the prevalence of depression in the elderly with chronic obstructive pulmonary disease (COPD).
Methods
The eighty-seven patients with COPD were enrolled. The subjects are over 60 years old. The medical and psychiatric history, Hamilton Rating Scale for Depression (HDRS), Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-2 (PHQ-2), Geriatric Depression Scale-Short form Korean (GDS-SF-K), Mini-Mental Status Exam Korean version (MMSE-KC) were investigated. Global Initiative for Chronic Obstructive Lung Disease (GOLD), which predict the severity of COPD, also investigated.
Results
The prevalence of depression was estimated to be 24.7% (male 19.3% ; female 35.7%) in HDRS, 31.0% (male 24.6% ; female 43.3%) in PHQ-9, 8.0% (male 10.5% ; female 3.3%) in PHQ-2, 23.0% (male 17.5% ; female 33.3%) in GDS-SF-K. The severity of COPD (GOLD) was associated with the prevalence of depression (HDRS, p=0.027 ; PHQ-9, p=0.045 ; PHQ-2, p=0.112 ; GDS-SFK, p=0.089).
Conclusion
The prevalence of elderly depression with COPD ranged from about 20% to 30%, the prevalence of depression is nearly two times more common in women. The severity of COPD (GOLD) was associated with the prevalence of depression. The self-reporting scale, such as GDS-SF-K, PHQ-9 and PHQ-2 is the effective screening test of depression.
Figures and Tables
Figure 1
ROC curve of GDS-SF-K, PHQ-9 and PHQ-2. GDS-SF-K (AUC=0.971, 95% CI 0.909-0.995), PHQ-9 (AUC=0.913 CI 0.832-0.963), PHQ-2 (AUC=0.781, 95% CI 0.678-0.863). ROC : Receiver operation characteristcs, AUC : Area under curve, GDS-SF-K : Geriatric Depression Scale-Short Form-Korea, PHQ-9 : Patient Health Questionnaire-9, PHQ-2 : Patient Health Questionnaire-2.
Table 2
Distribution of the mean score in HDRS, PHQ-9, GDS-SF-K, and MMSE-KC scores stratified by gender, age, educational level and living arrangement of the subjects
* : p<0.05, ** : p<0.01. HDRS : Hamilton Rating Scale for Depression, PHQ-9 : Patient Health Questionnaire-9, PHQ-2 : Patient Health Questionnaire-2, GDS-SF-K : Geriatric Depression Scale-Short Form-Korea, MMSE-KC : Korean version of MMSE in the Korean version of CERAD Assessment Packet, COPD : Chronic obstructive pulmonary disease
Table 3
Prevalence of depression in patients with COPD stratified by gender, age, educational and living arrangement of the subjects
Table 4
The frequencies of depression in the HDRS, PHQ-9 and GDS-SF-K scores stratified by cognitive function
Table 5
Correlations of the total scores of each scale
* : Correlation is significant at the 0.05 level (2-tailed), ** : Correlation is significant at the 0.01 level (2-tailed). HDRS : Hamilton Rating Scale for Depression, PHQ-9 : Patient Health Questionnaire-9, PHQ-2 : Patient Health Questionnaire-2, GDS-SF-K : Geriatric Depression Scale-Short Form-Korea, MMSE-KC : Korean version of MMSE in the Korean version of CERAD Assessment Packet
Acknowledgments
This study was supported by a grant of the Korean Health 21 Care Technology R & D Project, Ministry of Health and Welfare, Republic of Korea (A102065). This study was also supported by a grant of National Seoul Hospital.
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