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Depression Linked to Worsening Symptoms in COPD

Anxiety associated with longer exacerbations

FRIDAY, Oct. 24 (HealthDay News) -- Depression is associated with an increased risk of worsening symptoms and hospitalization in patients with chronic obstructive pulmonary disease (COPD), while anxiety nearly doubles the length of exacerbations, researchers report in the Nov. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

Wanning Xu, M.D., from McGill University in Montreal, Quebec, Canada, and colleagues studied 491 patients with stable COPD in China to determine the effect of depression and anxiety at baseline on the risk of COPD exacerbations and hospitalizations in the next 12 months.

The researchers recorded 876 symptom-based (worsening of at least one key symptom) and 450 event-based (at least one symptom worsening plus at least one change in regular medications) exacerbations. Of these, 183 led to hospitalization. Probable depression (a Hospital Anxiety and Depression Scale [HADS] depression score of 11 or more) was associated with a higher risk of symptom-based exacerbations (adjusted incidence rate ratio [IRR] 1.51), event-based exacerbations (adjusted IRR 1.56), and hospitalization (adjusted IRR 1.72) compared with no depression (HADS depression score of 7 or less). Patients with probable anxiety (HADS anxiety score of 11 or more) had event-based exacerbations that were 1.92 times longer than patients without anxiety (HADS anxiety score of 7 or less).

"This study suggests a possible causal effect of depression on COPD exacerbations and hospitalizations," Xu and colleagues conclude. "Thus, better detection and treatment of depression in patients with COPD may result in improved clinical outcomes and health resource utilization."

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