Depression May Worsen COPD

Oct. 24, 2008 -- Patients with a leading lung disease -- chronic obstructive pulmonary disease (COPD) -- might benefit from depression screening and depression treatment, if needed.

Chinese and Canadian researchers report that news in the American Journal of Respiratory and Critical Care Medicine.

They studied nearly 500 COPD patients aged 30 and older in Beijing. The patients completed surveys about depression and anxiety. Every month for a year, the patients reported any COPD flare-ups or hospitalizations.

The bottom line: Patients who were probably depressed, according to the depression surveys, had more COPD flare-ups and hospitalizations than COPD patients who weren't depressed. And anxious COPD patients tended to experience longer COPD flare-ups.

Those findings held regardless of other risk factors, according to the researchers, who included Wanning Xu, MSc, of McGill University in Montreal.

The study doesn't prove that depression worsens COPD, or that treating depression will ease COPD. But Xu's team says that's possible, based on these three theories:

• Depression may be linked to immune system changes that leave patients more vulnerable to environmental triggers.
• Depressed patients may be more sensitive to their COPD symptoms and more likely to report those symptoms.
• Depressed patients may not follow their treatment plans as well as other patients, making them more vulnerable to flare-ups.

Future research should test whether antidepressants and psychotherapy curb COPD flare-ups, note Xu and colleagues.