[Prevalence of Depressive Symptoms, Predictive Factors, and Diagnosis of Suspicion of Depression in Patients with COPD]

[慢性阻塞性肺疾病患者抑郁症状的患病率、预测因素及疑似抑郁症的诊断]

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Abstract

OBJECTIVE: to determine the prevalence of and predictive factors for depression in patients diagnosed with COPD and referred from primary care to pneumology departments, departments that share care for COPD patients. DESIGN: observational, multicentric, prospective with non-probabilistic sample, transversal study. SETTING: two pneumology visit offices at two hospitals offering different levels of care. PARTICIPANTS: 293 patients diagnosed with COPD in a stable phase of the disease. INTERVENTIONS: Carryng out common clinical questionnaires in COPD & HADS. MAIN MEASUREMENTS: Demographic, clinical, and functional variables of COPD, and HADS depression scale. RESULTS: Included were 229 men (78.16%) and 64 women (21.8%), with an average age of 68.2 ± 10.3 years of whom 93 (31.7%) were active smokers and 200 (68.3%) ex-smokers. 19.45% of patients had a previous diagnosis of clinical depression but the HADS test established a diagnosis of suspicion of depression in 32.6%. Predictive factors included: being female, living alone, and variables related to the severity of the disease (FEV1 postbronchodilator, being a high-risk patient, exacerbating phenotype criteria, and C and D GOLD criteria levels). CONCLUSIONS: The prevalence of depression in patients with COPD is high and is infra-diagnosed. The HADS diagnostic test is useful for establishing a diagnosis of suspicion of depression at primary care and pneumology visit offices. There are personal and clinical factors that may be considered predictive and aid healthcare professionals in determining which patients should take the HADS test and, based on results, referring patients to the mental health department to confirm or reject the diagnosis.

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