Effect of Depression on Pulmonary Symptoms and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Dre Kim; Songi Han; Sung Soo Jung; Ju Ock Kim; Sun Woo Lee

doi:10.4306/jknpa.2019.58.4.362

Journal List > J Korean Neuropsychiatr Assoc > v.58(4) > 1138965

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Han, Jung, Kim, and Lee: Effect of Depression on Pulmonary Symptoms and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Original Article

Journal of Korean Neuropsychiatric Association 2019; 58(4): 362-367.

Published online: 30 November 2019

DOI: https://doi.org/10.4306/jknpa.2019.58.4.362

Effect of Depression on Pulmonary Symptoms and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Dre Kim, MD^1,², Songi Han, MD^1,³, Sung Soo Jung, MD, PhD⁴, Ju Ock Kim, MD, PhD⁴, Sun Woo Lee, MD, PhD¹

¹Department of Psychiatry, Chungnam National University Hospital, Daejeon, Korea.

²Chungcheongbuk-do Office of Education, Cheongju, Korea.

³Institute of Forensic Psychiatry Ministry of Justice, Gongju, Korea.

⁴Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.

Address for correspondence: Sun Woo Lee, MD, PhD. Department of Psychiatry, Chungnam National University Hospital, 282 Munwha-ro, Jung-gu, Deajeon 35015, Korea. Tel +82-42-280-7502, Fax +82-42-280-7508, leesw@cnu.ac.kr

Received 1 July 2019 Revised 4 September 2019 Accepted 6 September 2019

Korean Neuropsychiatric Association

Abstract

Objectives

Depression is a common comorbid condition in patients with chronic obstructive pulmonary disease (COPD) and has a higher prevalence than the general population. On the other hand, studies on the incidence of depression and quality of life in COPD patients often depend on a simple self-report questionnaire rather than a psychiatrist's clinical assessment. Starting with accurately diagnosing depression, the purpose of this study was to evaluate the factors related to depression as well as how depression influences the quality of life.

Methods

The study included 30 patients diagnosed with COPD. All the patients were interviewed for a diagnosis of depression by a psychiatrist. They were divided into two groups: with and without depression. For dyspnea, the modified Medical Research Council (mMRC) scale was used to evaluate how it affected daily life. Short-Form Health Survey 36 and COPD assessment test (CAT) were used to assess the quality of life.

Results

The degree of COPD and respiratory symptoms were related, but the severity of COPD did not influence the quality of life. In the presence of depression, mMRC and CAT were higher, whereas PCS and MCS were lower than in those without depression. Patients with depression suffered more from dyspnea and had a lower quality of life.

Conclusion

This study suggests that the degree of COPD was not related to depression. With depression, however, it led to the aggravation of dyspnea and a deteriorated quality of life. Combined treatment is essential to improving the patients' general well-being.

Keywords: COPD, Depression, Quality of life

Figures and Tables

Table 1

Demographic characteristics in patients with chronic obstructive pulmonary disease

COPD : Chronic obstructive pulmonary disease, SD : Standard deviation

Table 2

Clinical characteristics in patients with chronic obstructive pulmonary disease

COPD : Chronic obstructive pulmonary disease, GOLD : Global Initiative for Chronic Obstructive Lung Disease, FEV1 : Forced expiratory volume in 1 second, SD : Standard deviation

Table 3

Significant clinical variables according to presence of depression

Variables are presented as mean (standard deviation). ^* : p<0.05, ^† : p<0.001. COPD : Chronic obstructive pulmonary disease, mMRC : Modified Medical Research Council, CAT : COPD assessment test, SF-36 : Short-Form Health Survey 36, PCS : Physical component summary, MCS : Mental component summary, K-HDRS : Korean version of Hamilton Depression Rating Scale-Revised

Table 4

Spearman correlation coefficient(r) between FEV1 and other clinical variables

^* : p<0.05, ^† : p<0.01, ^‡ : p<0.001. FEV1 : Forced expiratory volume in 1 second, PCS : Physical component summary, MCS : Mental component summary, CAT : COPD assessment test, mMRC : modified Medical Research Council, K-HDRS : Korean version of Hamilton Depression Rating Scale-Revised

Notes

^{Conflicts of Interest} The authors have no financial conflicts of interest.

References

1. Goldcopd.org [homepage on the internet]. Fontana: Global Initiative for Chronic Obstructive Lung Disease;cited 2018 July 2. Available from: https://goldcopd.org/gold-reports/.

2. Lopez AD, Shibuya K, Rao C, Mathers CD, Hansell AL, Held LS, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006; 27:397–412.

3. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3:2011–2030.

4. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997; 349:1498–1504.

5. Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007; 370:741–750.

6. Chun CM, Oh KW. Prevalence of chronic obstructive pulmonary disease among adults over 40 years old in Korea, 2009-2013. Public Health Wkly Rep. 2015; 8:334–337.

7. kostat.go.kr [homepage on the internet]. Daejeon: Statistics Korea;cited 2018 June 21. Available from: http://kosis.kr/publication/publicationThema.do.

8. Hillas G, Perlikos F, Tsiligianni I, Tzanakis N. Managing comorbidities in COPD. Int J Chron Obstruct Pulmon Dis. 2015; 10:95–109.

9. Hynninen KM, Breitve MH, Wiborg AB, Pallesen S, Nordhus IH. Psychological characteristics of patients with chronic obstructive pulmonary disease: a review. J Psychosom Res. 2005; 59:429–443.

10. Atlantis E, Fahey P, Cochrane B, Smith S. Bidirectional associations between clinically relevant depression or anxiety and COPD: a systematic review and meta-analysis. Chest. 2013; 144:766–777.

11. Solano JP, Gomes B, Higginson IJ. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage. 2006; 31:58–69.

12. Pumar MI, Gray CR, Walsh JR, Yang IA, Rolls TA, Ward DL. Anxiety and depression-Important psychological comorbidities of COPD. J Thorac Dis. 2014; 6:1615–1631.

13. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000; 160:2101–2107.

14. Ormel J, Kempen GI, Deeg DJ, Brilman EI, van Sonderen E, Relyveld J. Functioning, well-being, and health perception in late middleaged and older people: comparing the effects of depressive. J Am Geriatr Soc. 1998; 46:39–48.

15. Jang SM, Kim KU, Na HJ, Song SE, Lee SH, Lee H, et al. Depression is a major determinant of both disease-specific and generic health-related quality of life in people with severe COPD. Chron Respir Dis. 2019; 16:1–8.

16. Ryu YJ, Chun EM, Sim YS, Lee JH. Depression and anxiety in outpatients with chronic obstructive pulmonary disease. Tuberc Respir Dis. 2007; 62:11–18.

17. Chin HJ, Lee KH, Park CS, Son CW, Lee HY, Yu SK, et al. Prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease. Tuberc Respir Dis. 2008; 65:191–197.

18. Yohannes AM, Willgoss TG, Baldwin RC, Connolly MJ. Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. Int J Geriatr Psychiatry. 2010; 25:1209–1221.

19. Matte DL, Pizzichini MM, Hoepers AT, Diaz AP, Karloh M, Dias M, et al. Prevalence of depression in COPD: a systematic review and meta-analysis of controlled studies. Respir Med. 2016; 117:154–161.

20. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999; 54:581–586.

21. American Psychiatry Association. Diagnostic and statistical manual of mental disorders-DSM-IV. 4th ed. Seoul: Hana Medical Science Publish;1995.

22. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and reliability of the Korean version of the Hamilton Depression Rating Scale(K-HDRS). J Korean Neuropsychiatr Assoc. 2005; 44(4):456–465.

23. Koh SB, Chang SJ, Kang MG, Cha BS, Park JK. Reliability and validity on measurement instrument for health status assessment in occupational workers. Korean J Prev Med. 1997; 30:251–266.

24. Ware JE. User's manual for the SF-36v2 health. 2nd ed. Lincoln, RI: Quality Metric Incorporated;2007.

25. Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009; 34:648–654.

26. Hwang YI, Jung KS, Lim SY, Lee YS, Kwon NH. A validation study for the Korean version of Chronic Obstructive Pulmonary Disease Assessment Test (CAT). Tuberc Respir Dis (Seoul). 2013; 74:256–263.

27. Hansen MS, Fink P, Frydenberg M, Oxhøj M, Søndergaard L, Munk-Jørgensen P. Mental disorders among internal medical inpatients: prevalence, detection, and treatment status. J Psychosom Res. 2001; 50:199–204.

28. Kunik ME, Roundy K, Veazey C, Souchek J, Richardson P, Wray NP, et al. Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest. 2005; 127:1205–1211.

29. Yohannes AM, Müllerová H, Hanania NA, Lavoie K, Tal-Singer R, Vestbo J, et al. Long-term course of depression trajectories in patients with COPD: a 3-year follow-up analysis of the evaluation of COPD longitudinally to identify predictive surrogate endpoints cohort. Chest. 2016; 149:916–926.

30. Cao Z, Ong KC, Eng P, Tan WC, Ng TP. Frequent hospital readmissions for acute exacerbation of COPD and their associated factors. Respirology. 2006; 11:188–195.

31. Yohannes AM, Baldwin RC, Connolly MJ. Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease. Age Ageing. 2005; 34:491–496.

32. Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013; 187:347–365.

33. Hanania NA, Müllerova H, Locantore NW, Vestbo J, Watkins ML, Wouters EF, et al. Determinants of depression in the ECLIPSE chronic obstructive pulmonary disease cohort. Am J Respir Crit Care Med. 2011; 183:604–611.

34. Di Marco F, Verga M, Reggente M, Maria Casanova F, Santus P, Blasi F, et al. Anxiety and depression in COPD patients: the roles of gender and disease severity. Respir Med. 2006; 100:1767–1774.

35. Isoaho R, Keistinen T, Laippala P, Kivelä SL. Chronic obstructive pulmonary disease and symptoms related to depression in elderly persons. Psychol Rep. 1995; 76:287–297.

36. Regvat J, Žmitek A, Vegnuti M, Košnik M, Šuškovič S. Anxiety and depression during hospital treatment of exacerbation of chronic obstructive pulmonary disease. J Int Med Res. 2011; 39:1028–1038.

37. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA. 2000; 284:2606–2610.

38. Glassman AH, Helzer JE, Covey LS, Cottler LB, Stetner F, Tipp JE, et al. Smoking, smoking cessation, and major depression. JAMA. 1990; 264:1546–1549.

39. Wiesbeck GA, Kuhl HC, Yaldizli O, Wurst FM. WHO/ISBRA Study Group on Biological State and Trait Markers of Alcohol Use and Dependence. Tobacco smoking and depression--results from the WHO/ISBRA study. Neuropsychobiology. 2008; 57:26–31.

40. Ryu YJ, Chun EM, Lee JH, Chang JH. Prevalence of depression and anxiety in outpatients with chronic airway lung disease. Korean J Intern Med. 2010; 25:51–57.

41. Doyle T, Palmer S, Johnson J, Babyak MA, Smith P, Mabe S, et al. Association of anxiety and depression with pulmonary-specific symptoms in chronic obstructive pulmonary disease. Int J Psychiatry Med. 2013; 45:189–202.

TOOLS

Similar articles