Schane Rebecca E, Walter Louise C, Dinno Alexis, Covinsky Ken E, Woodruff Prescott G
Department of Medicine, Division of Pulmonary-Critical Care Medicine, Cardiovascular Research Institute, University of California, San Francisco, CA 94143-1390, USA.
J Gen Intern Med. 2008 Nov;23(11):1757-62. doi: 10.1007/s11606-008-0749-z. Epub 2008 Aug 9.
Although depression is a risk factor for adverse outcomes in chronic illness, little is known about the prevalence or risk factors for depressive symptoms in chronic obstructive pulmonary disease (COPD).
To determine the prevalence of depressive symptoms in COPD as compared to other chronic illnesses and to identify risk factors for depressive symptoms in COPD.
Cross-sectional study of 18,588 persons (1,736 subjects with self-reported COPD), representing a sample of the US population aged > or =50 years who participated in the 2004 Health and Retirement Survey.
Presence of COPD and other chronic conditions was defined by self-report. Presence of depressive symptoms was assessed using the CES-D8 scale. Participants with a score > or =3 on CES-D8 were classified as having clinically significant depressive symptoms.
Of 1,736 participants with COPD, 40% had > or =3 depressive symptoms. Depressive symptoms were more common in COPD than in coronary heart disease, stroke, diabetes, arthritis, hypertension, and cancer. Risk factors for > or =3 depressive symptoms in COPD: younger age (OR 1.02/per year younger, 95% CI [1.02-1.03]), female gender (1.2 [1.1-1.3]), current smoking (1.5 [1.3-1.7]), marital status [divorced/separated (1.8 [1.6-2.1]), widowed (1.8 [1.6-2]), never married (1.4 [1.1-1.8]), < or =high school degree (1.6 [1.5-1.8]), dyspnea (2.3 [2.1-2.6]), difficulty walking (2.8 [2.5-3.2]), and co-morbid diabetes (1.2 [1.1-1.4]), arthritis (1.3 [1.2-1.5]) or cancer (1.2 [1.1-1.4]).
Depressive symptoms are common in COPD and are more likely to occur in COPD than in other common chronic illnesses. The risk factors identified may be used for targeted depression screening in COPD patients.
尽管抑郁症是慢性疾病不良结局的一个风险因素，但对于慢性阻塞性肺疾病（COPD）患者抑郁症状的患病率或风险因素却知之甚少。
确定与其他慢性疾病相比，COPD患者抑郁症状的患病率，并识别COPD患者抑郁症状的风险因素。
对18588人进行横断面研究（1736名自我报告患有COPD的受试者），这些人代表了年龄≥50岁参与2004年健康与退休调查的美国人群样本。
COPD和其他慢性疾病的存在通过自我报告定义。使用CES-D8量表评估抑郁症状的存在情况。CES-D8得分≥3分的参与者被归类为有临床显著抑郁症状。
在1736名COPD参与者中，40%有≥3种抑郁症状。抑郁症状在COPD患者中比在冠心病、中风、糖尿病、关节炎、高血压和癌症患者中更常见。COPD患者出现≥3种抑郁症状的风险因素：年龄较小（每年年轻一岁，比值比为1.02，95%置信区间[1.02 - 1.03]）、女性（1.2[1.1 - 1.3]）、当前吸烟（1.5[1.3 - 1.7]）、婚姻状况[离婚/分居（1.8[1.6 - 2.1]）、丧偶（1.8[1.6 - 2]）、从未结婚（1.4[1.1 - 1.8]）]、高中及以下学历（1.6[1.5 - 1.8]）、呼吸困难（2.3[2.1 - 2.6]）、行走困难（2.8[2.5 - 3.2]）以及合并糖尿病（1.2[1.1 - 1.4]）、关节炎（1.3[1.2 - 1.5]）或癌症（1.2[1.1 - 1.4]）。
抑郁症状在COPD患者中很常见，并且与其他常见慢性疾病相比更可能在COPD患者中出现。所确定的风险因素可用于COPD患者的针对性抑郁筛查。
