Depression common with chronic lung disease

NEW YORK (Reuters Health) - Patients with severe chronic obstructive pulmonary disease often experience depressive symptoms, but relatively few receive antidepressant therapy, researchers report. Furthermore, these symptoms seem to increase the mortality risk.

Chronic obstructive pulmonary disease, also known as COPD, actually refers to two main lung diseases: emphysema and bronchitis. Although the lung damage seen with the diseases is different, they both involve changes that make it difficult for the patient to move air into and out of the lungs. Both are strongly linked to smoking.

"Depression in patients with COPD is associated with worse...quality of life," Dr. Vincent S. Fan, of the Veterans Affairs Puget Sound Health Care System, Seattle, and colleagues write in the Archives of Internal Medicine. "However, studies have not consistently found a higher risk of adverse clinical events among patients with COPD who have symptoms of depression or anxiety."

The researchers examined whether depressive or anxiety symptoms are associated with COPD-related hospitalization or death. Patients included in this study were identified from data collected from the National Emphysema Treatment Trial, a trial of surgery versus medical therapy for emphysema. A total of 603 treated with medical therapy were included in the present analysis.

Overall, 40.8 percent of subjects had at least mild-to-moderate depressive symptoms. Only 24.5 percent of these patients were taking an antidepressant.

Depressive symptoms did not affect COPD-related hospitalization, but did seem to increase the risk of death; patients with the most severe depressive symptoms were 2.74-times more likely to die within 3 years than were patients with little or no symptoms.

No association was observed between anxiety and hospitalization or death risk in these patients.

SOURCE: Archives of Internal Medicine, November 26, 2007.