Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression.

OBJECTIVE This meta-analysis was aimed to evaluate the differences in aggregated prevalence of depressive symptoms among people with chronic obstructive pulmonary disease (COPD) as compared to controls without COPD and to determine underlying moderators to explain potential heterogeneity of prevalence. METHODS A meta-analysis of published work was performed using the random effect model. A total of eight studies were identified. We calculated the differences in prevalence proportion of depressive symptoms in patients with COPD versus controls. Meta-regression and subgroup analysis were performed to identify factors that may contribute to heterogeneity. RESULTS The prevalence proportion of depressive symptoms was found to be significantly higher (pooled odds ratio: 2.81; 95% CI: 1.69-4.66) among 39587 individuals with COPD as compared to 39,431 controls (24.6%, 95% CI: 20.0-28.6% vs. 11.7%, 95% CI: 9-15.1%). Meta-regression was conducted to account for the heterogeneity of the prevalence proportion, but moderators like mean age, gender, mean FEV(1) and proportion of current smokers among COPD patients were nonsignificant and could not explain heterogeneity in prevalence of depressive symptoms. Subgroup analyses showed no significant differences based on different methods of assessment of depressive symptoms and countries sampled. CONCLUSION This meta-analytical review identified higher prevalence of depressive symptoms among COPD patients, and meta-regression showed that demographic and clinical factors were not the determinants of heterogeneity in prevalence of depressive symptoms.

[1]  M. Sullivan,et al.  Functional status and well being in chronic obstructive pulmonary disease with regard to clinical parameters and smoking: a descriptive and comparative study. , 1996, Thorax.

[2]  W. Bailey,et al.  Editorial: Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 Guidelines for COPD, Including COVID-19, Climate Change, and Air Pollution , 2023, Medical science monitor : international medical journal of experimental and clinical research.

[3]  S. Leeder,et al.  A population based study , 1993, The Medical journal of Australia.

[4]  S. Gregorich,et al.  Depression and health-related quality of life in chronic obstructive pulmonary disease. , 2009, The American journal of medicine.

[5]  A. Yohannes,et al.  Depression in elderly outpatients with disabling chronic obstructive pulmonary disease. , 1998, Age and ageing.

[6]  K. Freedland,et al.  The prevalence of comorbid depression in adults with diabetes: a meta-analysis. , 2001, Diabetes care.

[7]  J. Yzermans,et al.  Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review , 1999, Thorax.

[8]  L. Letenneur,et al.  Dyspnea and 8-year mortality among elderly men and women: The PAQUID cohort study , 2004, European Journal of Epidemiology.

[9]  L. Hedges,et al.  The Handbook of Research Synthesis and Meta-Analysis , 2009 .

[10]  S. Thompson,et al.  How should meta‐regression analyses be undertaken and interpreted? , 2002, Statistics in medicine.

[11]  U. Bothner,et al.  COPD and the risk of depression. , 2010, Chest.

[12]  F. Dekker,et al.  Risk of depression in patients with chronic obstructive pulmonary disease and its determinants , 2002, Thorax.

[13]  T. Ng,et al.  Co-morbid association of depression and COPD: a population-based study. , 2009, Respiratory medicine.

[14]  F. Zitman,et al.  Risk of depressive symptoms in the oldest old subjects with chronic obstructive pulmonary disease: the Leiden 85-plus study. , 2010, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[15]  J. Vestbo,et al.  Determinants of depression in the ECLIPSE chronic obstructive pulmonary disease cohort. , 2011, American journal of respiratory and critical care medicine.

[16]  R. Pauwels,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. , 2001, American journal of respiratory and critical care medicine.

[17]  Susan Murray,et al.  Sex differences in severe pulmonary emphysema. , 2007, American journal of respiratory and critical care medicine.

[18]  P. Bakke,et al.  A randomized controlled trial of cognitive behavioral therapy for anxiety and depression in COPD. , 2010, Respiratory medicine.

[19]  S. Gregorich,et al.  Depression and health-related quality of life in chronic obstructive pulmonary disease. , 2009, The American journal of medicine.

[20]  M. Dimatteo,et al.  Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. , 2000, Archives of internal medicine.

[21]  B. Digiovine,et al.  The Association Between Depressive Symptoms and Acute Exacerbations of COPD , 2009, Lung.

[22]  Dave Singh,et al.  Depression and its relationship with poor exercise capacity, BODE index and muscle wasting in COPD. , 2009, Respiratory medicine.

[23]  Office on Smoking.  The Health Consequences of Smoking: A Report of the Surgeon General , 2004 .

[24]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[25]  C. Wells,et al.  The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. , 1984, Chest.

[26]  K. Khunti,et al.  The prevalence of co‐morbid depression in adults with Type 2 diabetes: a systematic review and meta‐analysis , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[27]  Mark E Kunik,et al.  Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. , 2005, Chest.

[28]  Stephen W. Raudenbush,et al.  Analyzing effect sizes: Random-effects models. , 2009 .

[29]  Alan D. Lopez,et al.  The global burden of disease: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020. , 1996 .

[30]  Lung function growth in children with long-term exposure to air pollutants in Mexico City. , 2007 .

[31]  D. Mannino,et al.  Global burden of COPD: risk factors, prevalence, and future trends , 2007, The Lancet.

[32]  P. Coventry,et al.  Comprehensive pulmonary rehabilitation for anxiety and depression in adults with chronic obstructive pulmonary disease: Systematic review and meta-analysis. , 2007, Journal of psychosomatic research.

[33]  G. Erhabor,et al.  Specific psychiatric morbidity among patients with chronic obstructive pulmonary disease in a Nigerian general hospital. , 2001, Journal of psychosomatic research.