Department of Medicine, University of California San Francisco, CA 94143-0920, USA.
COPD. 2009 Dec;6(6):452-8. doi: 10.3109/15412550903341463.
Depression and chronic obstructive pulmonary disease (COPD) are major causes of disability. Identifying COPD patients at risk for depression would facilitate the alleviation of an important comorbidity conferring additional risk for poor outcomes. The purpose of this study was to determine the utility of a brief screening measure, the 15-item Geriatric Depression Scale (GDS-15), in detecting the mood disorders in persons with COPD. This is a cross-sectional study of 188 persons with COPD, stratified by age (65 and older versus less than 65) and COPD severity using Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging. Screening cut-points were empirically derived using threshold selection methods and receiver operating characteristic (ROC) curves were estimated. The GDS-15 was used as a screening measure and diagnoses of Major Depressive Disorder (MDD) or other mood disorders were determined using a "gold standard" standardized structured clinical interview. Of the 188 persons with COPD, 25% met criteria for any mood disorder and 11% met criteria for MDD. Optimal threshold estimations suggested a GDS cut score of 5, which yielded adequate sensitivity and specificity in detecting MDD (81% and 87%, respectively) and correctly classified 86% of participants. To detect the presence of any mood disorder, a cut score of 4 was suggested yielding sensitivity and specificity of 67% and 82%, respectively; correctly classifying 79%. These results suggest that mood disorders are relatively common among persons with COPD. The GDS-15 is a useful screening measure to identify patients at risk for depression.
抑郁和慢性阻塞性肺疾病（COPD）是导致残疾的主要原因。识别患有 COPD 且有抑郁风险的患者将有助于缓解这一重要的合并症，因为它会增加不良预后的风险。本研究的目的是确定一个简短的筛查工具——15 项老年抑郁量表（GDS-15），是否可以用于检测 COPD 患者的情绪障碍。这是一项对 188 名 COPD 患者的横断面研究，按年龄（65 岁及以上和<65 岁）和慢性阻塞性肺疾病全球倡议（GOLD）分期进行分层。使用阈值选择方法得出了筛查切点，并估计了接收者操作特征（ROC）曲线。使用 GDS-15 作为筛查工具，并使用“金标准”标准化结构临床访谈来确定是否患有重度抑郁症（MDD）或其他情绪障碍。在这 188 名 COPD 患者中，25%符合任何情绪障碍的标准，11%符合 MDD 的标准。最佳阈值估计表明 GDS 评分 5 分具有最佳的敏感性和特异性，用于检测 MDD（分别为 81%和 87%），并正确分类了 86%的参与者。要检测是否存在任何情绪障碍，建议使用 4 分的切点，其敏感性和特异性分别为 67%和 82%，正确分类率为 79%。这些结果表明，情绪障碍在 COPD 患者中较为常见。GDS-15 是一种有用的筛查工具，可以识别有抑郁风险的患者。
