High prevalence of depression alongside COPD can impact overall health, treatment effectiveness

American College of Chest PhysiciansMay 4 2016

Although there have been discussions about chronic obstructive pulmonary disease (COPD), a condition impacting 24 million Americans, and depression, there has been little research showing the impact depression has on patients with COPD. Two studies published in the April issue of the journal CHEST found one in four patients with COPD suffer from depressive symptoms, and if not treated, those symptoms can have a negative effect on their overall health and treatment effectiveness.

One study from Manchester Metropolitan University analyzed three-year data obtained from patients with COPD. The study showed that one in four patients with COPD had persistent depressive symptoms over three years. The odds of new onset depression increased with worse health status and moderate-to-severe breathlessness. Those with persistent or new-onset depression experience more exacerbations of COPD and more pronounced loss in performance. COPD exacerbations cause frequent hospital admissions, relapses and readmissions; contribute to death during hospitalizations or shortly thereafter; dramatically reduce the quality of life; consume financial resources; and hasten a progressive decline in pulmonary function, a cardinal feature of COPD. Hospitalizations due to exacerbations account for more than 50 percent of the cost of managing COPD in North America and Europe.

A second study from the University of Texas analyzed data from a random sample of five percent of Medicare beneficiaries diagnosed with COPD between 2001 and 2011 and found that 22.3 percent of those patients had one or more psychological disorders. The study showed that the odds of 30-day readmission were higher in patients with COPD who had depression, anxiety, psychosis, alcohol abuse and drug abuse compared with those who did not have these disorders.

"The prevalence of depression alongside COPD found in these two studies is alarming. Pulmonologists should consider the findings of this research when treating patients with COPD," said Dr. John Studdard, President-Designate, American College of Chest Physicians. "The impact of depression coupled with COPD on quality of life, exacerbation likelihood and readmissions should be further explored."