Comparative Impact of Depressive Symptoms and FEV% on Chronic Obstructive Pulmonary Disease.

TitleComparative Impact of Depressive Symptoms and FEV% on Chronic Obstructive Pulmonary Disease.
Publication TypePublication
Year2022
AuthorsO'Toole J, Woo H, Putcha N, Cooper CB, Woodruff P, Kanner RE, Paine R, Bowler RP, Comellas A, Hoth KF, Krishnan JA, Han ML, Dransfield M, Iyer AS, Couper D, Peters SP, Criner G, Kim V, R Barr G, Martinez FJ, Hansel NN, Eakin MN
Corporate AuthorsSPIROMICS Investigators
JournalAnn Am Thorac Soc
Volume19
Issue2
Pagination171-178
Date Published2022 Feb
ISSN2325-6621
KeywordsDepression, Female, Forced Expiratory Volume, Humans, Pulmonary Disease, Chronic Obstructive, quality of life, Respiratory Function Tests, smoking, Surveys and Questionnaires
Abstract

Individuals with chronic obstructive pulmonary disease (COPD) have a high prevalence of depression, which is associated with increased COPD hospitalizations and readmissions. Examine the impact of depressive symptoms compared with FEV% on COPD morbidity. Using longitudinal data from individuals with COPD in the Subpopulations and Intermediate Outcome Measures in COPD Study, longitudinal growth analysis was performed to assess COPD morbidity by assessing differences in baseline 6-minute walk distance and patient reported outcomes (PROs) and their rate of change over time explained by depressive symptoms or lung function, as measured by Hospital Anxiety and Depression Scale or FEV% respectively. PROs consisted of in-person completion of St. George's Respiratory Questionnaire, COPD Assessment Test, Functional Assessment of Chronic Illness Therapy Fatigue, and Modified Medical Research Council Dyspnea Scale measures. Of the individuals analyzed ( = 1,830), 43% were female, 81% Caucasian with mean ± SD age of 65.1 ± 8.1, and 52.7 ± 27.5 pack-years smoking. Mean ± SD FEV% was 60.9 ± 23.0% and 20% had clinically significant depressive symptoms. Adjusted models showed higher Hospital Anxiety and Depression Scale scores and lower FEV% each were associated with worse PROs at baseline ( ⩽ 0.001). Depression accounted for more baseline variance in St. George's Respiratory Questionnaire, COPD Assessment Test, and Functional Assessment of Chronic Illness Therapy Fatigue than FEV%, explaining 30-67% of heterogeneity. FEV% accounted for more baseline variance in Modified Medical Research Council Dyspnea Scale and 6-minute walk distance than depression, explaining 16-32% of heterogeneity. Depressive symptoms accounted for 3-17% variance in change over time in PROs. In contrast, FEV% accounted for 1-4% variance over time in PROs. Depression is more strongly associated with many PROs at baseline and their change over time compared with FEV%. Recognizing and incorporating the impact of depressive symptoms into individualized care may improve COPD outcomes.

DOI10.1513/AnnalsATS.202009-1187OC
Alternate JournalAnn Am Thorac Soc
PubMed ID34410883
PubMed Central IDPMC8867359
Grant ListR01ES023500 / ES / NIEHS NIH HHS / United States
R01 ES023500 / ES / NIEHS NIH HHS / United States
R01 HL128620 / HL / NHLBI NIH HHS / United States
F32 HL143864 / HL / NHLBI NIH HHS / United States
K23 HL123594 / HL / NHLBI NIH HHS / United States
MS#: 
MS174
Manuscript Full Title: 
Comparative Impact of Depressive Symptoms and FEV% on Chronic Obstructive Pulmonary Disease.
Manuscript Lead/Corresponding Author Affiliation: 
Clinical Center: Baltimore (Johns Hopkins University)
ECI: 
Manuscript Status: 
Published and Public