Depression alert in Asian COPD patients

Data from Taiwan indicate that patients with chronic obstructive pulmonary disease (COPD) are nearly twice as likely as other patients to develop depression.

Researchers Fung-Chang Sung (China Medical University, Taichung, Taiwan) and colleagues found that the risk was particularly high within the year following COPD diagnosis and then declined over time.

Noting that the stigma around mental illness may prevent Asian patients from openly discussing symptoms of depression, they say: “The need to routinely screen COPD patients for depression and institute culturally appropriate interventions should be emphasized, especially within the first year since COPD diagnosis.”

The team analyzed national insurance database data, identifying 38,010 COPD patients who were diagnosed between 2000 and 2004, and an equal number of age- and gender-matched controls.

By the end of 2008, 4109 patients overall had been newly diagnosed with depression. In multivariate analysis, those with COPD were 88% more likely to have depression, at a rate of 12.2 per 1000 person–years compared with 6.5 per 1000 person–years among controls.

The team notes that the risk for depression fell with time since COPD diagnosis from a 2.01-fold increased risk in the subsequent year to a 1.40-fold increased risk after year 5.

Women were at particular risk for depression during follow-up, being 1.19-fold more likely to develop it than men. Additionally, being younger, having a lower monthly income, and being hospitalized were all associated with the likelihood for depression, as were certain comorbidities, including heart disease, arthritis, cancer, and hypertension.

“These findings suggest that healthcare providers need to pay closer attention to newly diagnosed patients with COPD, particularly inpatients,” Sung and colleagues write in BMC Public Health.

They say that their findings reflect those previously reported in Western populations and add to scant information on the presence of depression among Asian COPD patients, who they say may find it a particularly embarrassing condition to seek treatment for.

“Therefore, the implementation of a standardized care process, including some screening tools applicable to COPD patients, may be of utmost importance,” they conclude.

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