Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1999 Aug;54(8):688–692. doi: 10.1136/thx.54.8.688

Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review

L van Ede 1, C Yzermans 1, H Brouwer 1
PMCID: PMC1745552  PMID: 10413720

Abstract

BACKGROUND—Patients with chronic obstructive pulmonary disease (COPD) have repeatedly been characterised as a population of chronically ill patients with a higher than normal prevalence of depression. Susceptibility for depression has been noted in patients with certain other chronic conditions. This systematic review was conducted to achieve a more definite answer to the question: do patients with COPD show a higher than normal prevalence of depression?
METHODS—Studies in English language journals were retrieved by an electronic search over the period from 1966 to December 1997 and by an extended search of reference lists, and were included or excluded according to a system of diagnostic and methodological criteria.
RESULTS—Ten studies were included, of which only four had a case-control design. Three of the case-control studies reported an increased prevalence of depression among patients with COPD which was statistically significant in only one. The fourth controlled study found a significantly increased depression score among COPD patients. Of the remaining six uncontrolled studies three found a high baseline prevalence of depression among their study group.
CONCLUSIONS—An association between COPD and depression was found in the four controlled studies. The two methodologically best conducted studies that did not detect a statistically significant higher prevalence lacked power. The two studies that did find a significant association used a questionable depression measure. The prevalence of depression was high compared with general population figures in three of six non-controlled studies. The empirical evidence for a significant risk of depression in patients with COPD remains inconclusive, due to the poor methodological quality of most of the published studies, the lack of studies with an adequate sample size, and variability in instruments and cut off scores used to measure depression.



Full Text

The Full Text of this article is available as a PDF (90.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agrell B., Dehlin O. Comparison of six depression rating scales in geriatric stroke patients. Stroke. 1989 Sep;20(9):1190–1194. doi: 10.1161/01.str.20.9.1190. [DOI] [PubMed] [Google Scholar]
  2. Bijl R. V., van Zessen G., Ravelli A. Psychiatrische morbiditeit onder volwassenen in Nederland: het NEMESIS-onderzoek. II. Prevalentie van psychiatrische stoornissen. Ned Tijdschr Geneeskd. 1997 Dec 13;141(50):2453–2460. [PubMed] [Google Scholar]
  3. Burrows B. Differential diagnosis of chronic obstructive pulmonary disease. Chest. 1990 Feb;97(2 Suppl):16S–18S. doi: 10.1378/chest.97.2_supplement.16s. [DOI] [PubMed] [Google Scholar]
  4. Dudley D. L., Glaser E. M., Jorgenson B. N., Logan D. L. Psychosocial concomitants to rehabilitation in chronic obstructive pulmonary disease. Part 2. Psychosocial treatment. Chest. 1980 Apr;77(4):544–551. doi: 10.1378/chest.77.4.544. [DOI] [PubMed] [Google Scholar]
  5. Dudley D. L., Glaser E. M., Jorgenson B. N., Logan D. L. Psychosocial concomitants to rehabilitation in chronic obstructive pulmonary disease. Part I. Psychosocial and psychological considerations. Chest. 1980 Mar;77(3):413–420. doi: 10.1378/chest.77.3.413. [DOI] [PubMed] [Google Scholar]
  6. Engström C. P., Persson L. O., Larsson S., Rydén A., Sullivan M. Functional status and well being in chronic obstructive pulmonary disease with regard to clinical parameters and smoking: a descriptive and comparative study. Thorax. 1996 Aug;51(8):825–830. doi: 10.1136/thx.51.8.825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gift A. G., McCrone S. H. Depression in patients with COPD. Heart Lung. 1993 Jul-Aug;22(4):289–297. [PubMed] [Google Scholar]
  8. Gordon G. H., Michiels T. M., Mahutte C. K., Light R. W. Effect of desipramine on control of ventilation and depression scores in patients with severe chronic obstructive pulmonary disease. Psychiatry Res. 1985 May;15(1):25–32. doi: 10.1016/0165-1781(85)90036-8. [DOI] [PubMed] [Google Scholar]
  9. Greenberg G. D., Ryan J. J., Bourlier P. F. Psychological and neuropsychological aspects of COPD. Psychosomatics. 1985 Jan;26(1):29–33. doi: 10.1016/S0033-3182(85)72902-7. [DOI] [PubMed] [Google Scholar]
  10. Isoaho R., Keistinen T., Laippala P., Kivelä S. L. Chronic obstructive pulmonary disease and symptoms related to depression in elderly persons. Psychol Rep. 1995 Feb;76(1):287–297. doi: 10.2466/pr0.1995.76.1.287. [DOI] [PubMed] [Google Scholar]
  11. Johnson G., Burvill P. W., Anderson C. S., Jamrozik K., Stewart-Wynne E. G., Chakera T. M. Screening instruments for depression and anxiety following stroke: experience in the Perth community stroke study. Acta Psychiatr Scand. 1995 Apr;91(4):252–257. doi: 10.1111/j.1600-0447.1995.tb09778.x. [DOI] [PubMed] [Google Scholar]
  12. Jones P. W., Baveystock C. M., Littlejohns P. Relationships between general health measured with the sickness impact profile and respiratory symptoms, physiological measures, and mood in patients with chronic airflow limitation. Am Rev Respir Dis. 1989 Dec;140(6):1538–1543. doi: 10.1164/ajrccm/140.6.1538. [DOI] [PubMed] [Google Scholar]
  13. Karajgi B., Rifkin A., Doddi S., Kolli R. The prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease. Am J Psychiatry. 1990 Feb;147(2):200–201. doi: 10.1176/ajp.147.2.200. [DOI] [PubMed] [Google Scholar]
  14. Kessler R. C., McGonagle K. A., Zhao S., Nelson C. B., Hughes M., Eshleman S., Wittchen H. U., Kendler K. S. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994 Jan;51(1):8–19. doi: 10.1001/archpsyc.1994.03950010008002. [DOI] [PubMed] [Google Scholar]
  15. Light R. W., Merrill E. J., Despars J. A., Gordon G. H., Mutalipassi L. R. Prevalence of depression and anxiety in patients with COPD. Relationship to functional capacity. Chest. 1985 Jan;87(1):35–38. doi: 10.1378/chest.87.1.35. [DOI] [PubMed] [Google Scholar]
  16. McSweeny A. J., Grant I., Heaton R. K., Adams K. M., Timms R. M. Life quality of patients with chronic obstructive pulmonary disease. Arch Intern Med. 1982 Mar;142(3):473–478. [PubMed] [Google Scholar]
  17. Prigatano G. P., Wright E. C., Levin D. Quality of life and its predictors in patients with mild hypoxemia and chronic obstructive pulmonary disease. Arch Intern Med. 1984 Aug;144(8):1613–1619. [PubMed] [Google Scholar]
  18. Ries A. L., Kaplan R. M., Limberg T. M., Prewitt L. M. Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Ann Intern Med. 1995 Jun 1;122(11):823–832. doi: 10.7326/0003-4819-122-11-199506010-00003. [DOI] [PubMed] [Google Scholar]
  19. Sandhu H. S. Psychosocial issues in chronic obstructive pulmonary disease. Clin Chest Med. 1986 Dec;7(4):629–642. [PubMed] [Google Scholar]
  20. Spinhoven P., Ormel J., Sloekers P. P., Kempen G. I., Speckens A. E., Van Hemert A. M. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997 Mar;27(2):363–370. doi: 10.1017/s0033291796004382. [DOI] [PubMed] [Google Scholar]
  21. Wilkinson M. J., Barczak P. Psychiatric screening in general practice: comparison of the general health questionnaire and the hospital anxiety depression scale. J R Coll Gen Pract. 1988 Jul;38(312):311–313. [PMC free article] [PubMed] [Google Scholar]
  22. Williams S. J. Chronic respiratory illness and disability: a critical review of the psychosocial literature. Soc Sci Med. 1989;28(8):791–803. doi: 10.1016/0277-9536(89)90108-1. [DOI] [PubMed] [Google Scholar]
  23. Yellowlees P. M. The treatment of psychiatric disorders in patients with chronic airways obstruction. Med J Aust. 1987 Oct 5;147(7):349–352. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES