Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
J Korean Med Sci. 2013 Jul;28(7):1048-54. doi: 10.3346/jkms.2013.28.7.1048. Epub 2013 Jul 3.
This study was conducted to investigate the association between the chronic obstructive pulmonary disease (COPD) assessment test (CAT) and depression in COPD patients. The Korean versions of the CAT and patient health questionnaire-9 (PHQ-9) were used to assess COPD symptoms and depressive disorder, respectively. In total, 803 patients with COPD were enrolled from 32 hospitals and the prevalence of depression was 23.8%. The CAT score correlated well with the PHQ-9 score (r=0.631; P<0.001) and was significantly associated with the presence of depression (β±standard error, 0.452±0.020; P<0.001). There was a tendency toward increasing severity of depression in patients with higher CAT scores. By assessment groups based on the 2011 Global Initiative for Chronic Obstructive Lung Disease guidelines, the prevalence of depression was affected more by current symptoms than by airway limitation. The area under the receiver operating characteristic curve for the CAT was 0.849 for predicting depression, and CAT scores ≥21 had the highest accuracy rate (80.6%). Among the eight CAT items, energy score showed the best correlation and highest power of discrimination. CAT scores are significantly associated with the presence of depression and have good performance for predicting depression in COPD patients.
本研究旨在探讨慢性阻塞性肺疾病（COPD）评估测试（CAT）与 COPD 患者抑郁之间的关系。采用韩文版 CAT 和患者健康问卷-9（PHQ-9）分别评估 COPD 症状和抑郁障碍。总共从 32 家医院招募了 803 名 COPD 患者，抑郁的患病率为 23.8%。CAT 评分与 PHQ-9 评分高度相关（r=0.631；P<0.001），与抑郁的存在显著相关（β±标准误差，0.452±0.020；P<0.001）。CAT 评分较高的患者，抑郁严重程度呈上升趋势。根据 2011 年全球慢性阻塞性肺疾病倡议指南的评估组，当前症状对抑郁的患病率影响大于气道限制。CAT 预测抑郁的受试者工作特征曲线下面积为 0.849，CAT 评分≥21 具有最高的准确率（80.6%）。在 CAT 的八项条目，能量评分显示出最佳的相关性和最高的判别力。CAT 评分与抑郁的存在显著相关，对 COPD 患者抑郁具有良好的预测性能。
