Gerontological Research Programme, Faculty of Medicine, National University of Singapore (NTP, MN), National University Hospital, 5 Lower Kent Ridge Road, Singapore.
Respir Med. 2009 Jun;103(6):895-901. doi: 10.1016/j.rmed.2008.12.010. Epub 2009 Jan 10.
Depression occurs commonly among patients with COPD, but the independent association of depression and COPD and the effect of depression on COPD outcomes are not well established.
A population sample of 2402 Chinese aged >or=55 with and without COPD (characteristic symptoms of chronic cough, sputum or breathlessness and airflow obstruction and FEV(1)/FVC<0.70) was assessed on Geriatric Depression Scale (score>or=5), dependence on basic activities of daily living (ADL), SF-12 health status, smoking and medication behaviour.
The 189 respondents with COPD showed higher depressive symptoms prevalence (22.8%) than 2213 respondents without COPD (12.4%); multivariate odd ratio (OR) was 1.86; 95% CI, 1.25-2.75 after controlling for confounding risk factors. In multivariate analyses of respondents with COPD, those who were depressed (N=43), compared to those who were not (N=146), were more likely to report ADL disability (OR=2.89, p=0.049) poor or fair self-reported health (OR=3.35, p=0.004), poor SF-12 PCS scores (OR=2.35, p=0.041) and SF-12 MCS scores (OR=4.17, p<0.001).
Depressive symptoms were associated with COPD independent of known risk factors. In COPD participants, depressive symptoms were associated with worse health and functional status and self-management.
COPD 患者常发生抑郁，但抑郁与 COPD 的独立相关性以及抑郁对 COPD 结局的影响尚不清楚。
对 2402 名年龄≥55 岁的中国人群进行了一项基于人群的研究，这些人或患有 COPD（慢性咳嗽、咳痰或呼吸困难和气流受限的特征性症状，以及 FEV1/FVC<0.70），或不患有 COPD（无上述特征性症状）。使用老年抑郁量表（得分≥5 分）、日常生活活动（ADL）依赖、SF-12 健康状况、吸烟和用药行为对患者进行评估。
189 名 COPD 患者的抑郁症状发生率（22.8%）高于 2213 名不患有 COPD 的患者（12.4%）；多变量比值比（OR）为 1.86；在控制混杂危险因素后，95%置信区间（CI）为 1.25-2.75。在对患有 COPD 的患者进行的多变量分析中，与未患有 COPD 的患者（n=146）相比，患有抑郁（n=43）的患者更有可能报告 ADL 残疾（OR=2.89，p=0.049）、自我报告健康状况较差或一般（OR=3.35，p=0.004）、SF-12 PCS 评分较差（OR=2.35，p=0.041）和 SF-12 MCS 评分较差（OR=4.17，p<0.001）。
抑郁症状与 COPD 独立于已知的危险因素相关。在 COPD 患者中，抑郁症状与更差的健康和功能状态以及自我管理相关。
