Relationship between depression and exacerbations in chronic obstructive pulmonary disease

¹ Academic Unit of Respiratory Medicine, University College London, London, UK

^* To whom correspondence should be addressed. E-mail: j.a.wedzicha{at}medsch.ucl.ac.uk.

	Abstract

Chronic obstructive pulmonary disease is associated with exacerbations. Some patients are prone to frequent exacerbations and these individuals have worse quality of life, greater limitation of their daily activity and faster disease progression than patients with less frequent exacerbations.

We performed a prospective study in a well characterised cohort and assessed whether depression, as assessed by the Centre for Epidemiologic Studies Depression Scale was related to exacerbation frequency, systemic inflammation and various social factors. We also investigated the associations of any increase in depressive symptoms at exacerbation.

Frequent exacerbators had a significantly higher baseline depression score than infrequent exacerbators (17.7 (12.4) and 13.6 (10.0) respectively); p=0.03. Depressed patients spend less time outdoors; r= -0.34, p=0.001 and had worse quality of life as measured by the SGRQ; r=0.47, p<0.001. Depression increased significantly in patients from baseline to exacerbation; 14.6 (11.8) and 20.3 (10.4) respectively; p<0.001.

This is the first study to show a relationship between depression and exacerbation frequency in patients with COPD. The finding that frequent exacerbators are more depressed than infrequent exacerbators is relevant, as exacerbation frequency is an important outcome measure in COPD.

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