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Cited by 171Chronic Obstructive Pulmonary Disease (COPD) ResearchCardiac Health and Mental HealthAsthma and respiratory diseases

Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease

Fan, Vincent S.·2007·Archives of Internal Medicine
DOI 10.1001/archinte.167.21.2345
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Abstract

BACKGROUND: We sought to determine whether depressive or anxiety symptoms are associated with chronic obstructive pulmonary disease (COPD) hospitalization or mortality. These data were collected as part of the National Emphysema Treatment Trial (NETT), a randomized controlled trial of lung volume reduction surgery vs continued medical treatment conducted at 17 clinics across the United States between January 29, 1998, and July 31, 2002. METHODS: Prospective cohort study among participants in the NETT with emphysema and severe airflow limitation who were randomized to medical therapy. Primary outcomes were 1- and 3-year mortality, as well as COPD or respiratory-related hospitalization or emergency department visit during the 1-year follow-up period. Of 610 patients randomized to medical therapy, complete data on hospitalization and mortality were available for 3 years of follow-up for 603 patients (98.9%). RESULTS: Depressive symptoms were assessed using the Beck Depression Inventory (BDI) questionnaire, and anxiety was assessed using the State-Trait Anxiety Inventory. Among 610 subjects, 40.8% had at least mild to moderate depressive symptoms. Patients in the highest quintile of BDI score (BDI score, >or=15) had an increased risk of respiratory hospitalization in unadjusted analysis compared with patients in the lowest quintile (BDI score, < 5) (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.30-3.93). After adjustment for disease severity, this relationship was no longer statistically significant. The adjusted risk of 3-year mortality was increased among those in the highest quintile of BDI score (OR, 2.74; 95% CI, 1.42-5.29) compared with those in the lowest quintile. Anxiety was not associated with hospitalization or mortality in this population. CONCLUSIONS: Depressive symptoms are common in patients with severe COPD and are treated in few subjects. Depressive symptoms are associated with increased risk for 3-year mortality but not 1-year mortality or hospitalization.

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  • In the National Emphysema Treatment Trial, the mortality rate among depressed patients during a 3-year period was increased.

    “In the same trial,62 the mortality rate among depressed patients during a 3-year period was increased.”

    From Anxiety and Depression in COPD (2008) · cites this paper as [62]

  • In the National Emphysema Treatment Trial, depression increases all hospitalizations, including hospitalizations for respiratory conditions and COPD hospitalizations.

    “Results from the National Emphysema Treatment Trial62 reveal that depression increases all hospitalizations, including hospitalizations for respiratory conditions and COPD hospitalizations.”

    From Anxiety and Depression in COPD (2008) · cites this paper as [62]

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Authors
Fan, V. S.
Affiliations
Health Services Research & Development (US)
Corresponding author
Fan, Vincent S.
ORCID
Fan, Vincent S.
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2007-11-26
Volume
167
Issue
21
Pages
2345
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.167.21.2345
OpenAlex
W2140452260
Cited by
171
References
50
Citations by year
2026: 2 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 8 · 2017: 11 · 2016: 14 · 2015: 19 · 2014: 17 · 2013: 8 · 2012: 15
FWCI
10.56
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (n01hr076109-006, n01hr076108-002, n01hr076114-001, n01hr076105-002, n01hr076104-001, n01hr076107-006, n01hr076112-000, n01hr076110-005, n01hr076118-007, n01hr076111-002, n01hr076119-008, n01hr076102-007, n01hr076115-008, n01hr076116-002, n01hr076101-006, n01hr076113-000, n01hr076106-002, n01hr076103-001)
  • National Heart, Lung, and Blood Institute (N01HR76118, N01 HR 76111, N01-HR76119, N01 HR 76102, N01HR76110, N01 HR 76109, N01 HR 76104, N01HR76106, N01HR76108, N01HR76101, N01HR76115, N01 HR76103, N01 HR 76116, N01HR76114, N01 HR76113, N01HR76112, N01 HR76107, N01 HR 76105)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
Keywords
chronic obstructive pulmonary disease, depressive symptoms, anxiety, sex differences, mortality, hospitalization, emphysema, lung volume reduction surgery, National Emphysema Treatment Trial, Beck Depression Inventory, State-Trait Anxiety Inventory
MeSH terms
Aged, Antidepressive Agents, Depression, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Risk Factors, Sex Factors, United States, Survival Rate, Multivariate Analysis, Logistic Models, Pulmonary Disease, Chronic Obstructive

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