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Article Start
Chronic obstructive pulmonary disease (COPD) causes limitation of
airflow in the lungs that cannot be fully reversed, leading to
symptoms of breathlessness, cough, wheeze and sputum production.
The disease, although chronic, is interspersed with periods of acute
symptomatic and functional deterioration known as exacerbations.
Exacerbations have important consequences for patients and their
healthcare providers.
It is not fully understood why some individuals with COPD are prone
to frequent exacerbations (three or more per year), however, it is
known that these individuals have worse quality of life, greater
limitation of daily activity and faster disease progression than
infrequent exacerbators (patients who have fewer than three
exacerbations per year). Depression is a recognised complication of
many chronic diseases, including COPD, and this also affects quality
of life.
In this study, Jadwiga Wedzicha (Academic Unit of Respiratory
Medicine, University College London, UK) and his colleagues
prospectively investigated 169 patients over a one-year period and
assessed whether depressive symptoms increased at the time of an
exacerbation and whether depression was related to exacerbation
frequency.
They find that depressive symptoms are significantly higher at
exacerbation than at baseline. The authors also find that frequent
exacerbators have significantly higher depression scores in the
stable state compared to infrequent exacerbators.
Patients who are depressed have a poorer quality of life, increased
breathlessness, spend less time outdoors, and are more likely to be
female and live alone.
The British team concludes that lack of recognition of depression may
have implications for uptake and completion of treatment, including
pulmonary rehabilitation, and propose that frequent exacerbators
should be screened routinely and treated for depression if appropriate.
This may help maximise patient outcome and quality of life in COPD.
Title Of The Original Article
Relationship between depression and exacerbations in COPD
The European Respiratory Journal is the peer-reviewed scientific publication
of the European Respiratory Society (more than 8,000 specialists in lung
diseases and respiratory medicine in Europe, the United States and
Australia).
European Respiratory Journal
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