Current perspectives on management of co-morbid depression in COPD.

Individuals with COPD have a higher prevalence of co-morbid depression than either the general population or patients with other chronic illnesses. The best estimates report a prevalence of approximately 40% in COPD patients, compared to 15% in the general population. Depression in COPD patients leads to a lower quality of life, greater objective impairment in function, and decreased adherence to therapeutic interventions. While many depressed COPD patients have been treated empirically with antidepressants--subjecting them to antidepressant side effects, toxicities, and costs--there is a surprising lack of evidence supporting or directing that treatment. We review the current literature regarding the management of depression in COPD, suggest strategies for management, and future research needs.