Depression and quality of life in patients with severe chronic obstructive pulmonary disease - A cross sectional study

Background: We assessed the prevalence of depression and quality of life and their associations in patients with severe and very severe COPD. Materials and methods: Sixty individuals who gave consent and who met the gold criteria for severe and very severe COPD were recruited for the study. The results of spirometry (FEV1%) which gives the severity of COPD were noted. The recruited individuals were screened for depression through a clinical interview and ICD-10 criterion was used to diagnose depression. The severity of depression of each individual participating in the study was estimated using Hamilton Depression Rating and the quality of life of each individual was estimated using the WHO Quality of Life Questionnaire ?BREF Version. Results: Mean age of the patients was 53±4.5 years. The duration of COPD was 8.68±4.3 years. 93.3% of the individuals recruited for the study had severe COPD. 68.3% had been mild to severe depression while 31.7% were normal. The mean HAM-D and quality of life total score of these patients were 17±9.09 and 52±15.1 respectively. HAM-D scores in patients suffering from very severe COPD were much higher when compared to that of patients suffering with severe COPD. Patients with severe depression have poor quality of life on all aspects in comparison with moderate and mildly depressed. Numbers of exacerbations and hospitalizations have a significant correlation with severity of depression and a significant negative correlation with all domains of quality of life. Conclusion: The prevalence of depression in patients with severe to very severe COPD is as high as 68.3%. There was a positive correlation between the number of hospitalizations and exacerbations to the severity of depression. Quality of life in COPD patients with depression was found to be poor in all the four domains namely physical, psychological, social and environmental when compared to those having only COPD as an illness. The severity of COPD was positively correlated with severity of depression and showed a negative correlation with the quality of life.