Prevalence of depression in stable chronic obstructive pulmonary disease

Psychological impairment is a significant co-morbid condition of chronic obstructive pulmonary disease (COPD). No studies from India have been conducted to assess the prevalence of depression in COPD.

We investigated the prevalence of depression in 100 consecutive stable COPD patients during their routine outpatient department visits. Patients diagnosed to have depression or chronic systemic diseases were excluded. Severity of the COPD was classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Hindi translations of patient health questionnaire-9 (PHQ-9) were administered and severity of depression was assessed at each stage of the COPD.

All subjects were males with a mean age of 61.7 +/- 9.6 years. Six patients in stage I, 32 patients in stage II, 40 patients in stage III and 22 patients in stage IV of the COPD were enrolled. The cumulative prevalence of depression in the study population was 72 percent.

Symptoms of depression were observed at all stages of COPD and its severity increased with an increase in severity of the COPD. High prevalence of depressive symptoms in Indian patients with COPD may be due to various confounding factors. Screening for symptoms of depression in patients with COPD by simple and quick validated questionnaires during their out-patient visits will be helpful in early diagnosis and appropriate treatment or referral.