Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review
Open accessAbstract
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have repeatedly been characterised as a population of chronically ill patients with a higher than normal prevalence of depression. Susceptibility for depression has been noted in patients with certain other chronic conditions. This systematic review was conducted to achieve a more definite answer to the question: do patients with COPD show a higher than normal prevalence of depression? METHODS: Studies in English language journals were retrieved by an electronic search over the period from 1966 to December 1997 and by an extended search of reference lists, and were included or excluded according to a system of diagnostic and methodological criteria. RESULTS: Ten studies were included, of which only four had a case-control design. Three of the case-control studies reported an increased prevalence of depression among patients with COPD which was statistically significant in only one. The fourth controlled study found a significantly increased depression score among COPD patients. Of the remaining six uncontrolled studies three found a high baseline prevalence of depression among their study group. CONCLUSIONS: An association between COPD and depression was found in the four controlled studies. The two methodologically best conducted studies that did not detect a statistically significant higher prevalence lacked power. The two studies that did find a significant association used a questionable depression measure. The prevalence of depression was high compared with general population figures in three of six non-controlled studies. The empirical evidence for a significant risk of depression in patients with COPD remains inconclusive, due to the poor methodological quality of most of the published studies, the lack of studies with an adequate sample size, and variability in instruments and cut off scores used to measure depression.
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Systematic reviews report that the prevalence of depression in COPD ranges between 7% and 42%.
“Systematic reviews state that the prevalence of depression ranges between 7% and 42% [10]”
From A psychological intervention to promote acceptance and adherence to non-invasive ventilation in people with chronic obstructive pulmonary disease: study protocol of a randomised controlled trial. (2017) · cites this paper as [10]
The Results report a 6–42% range among the six uncontrolled COPD studies, not 7–42%. They also report 7% in one controlled study, so the cited review supports the upper bound and contains the 7% figure, but not the stated range as the overall range. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThere is a paucity of well-designed studies on depression as a comorbidity in COPD.
“van Ede et al76 noted the paucity of well-designed studies on depression as a comorbidity in COPD.”
From Anxiety and Depression in COPD (2008) · cites this paper as [76]
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- Authors
- van Ede, L., Yzermans, C. J., & Brouwer, H. J.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 1999-08-01
- Volume
- 54
- Issue
- 8
- Pages
- 688-692
- ISSN
- 0040-6376 (ISSN-L)
- PMC
- PMC1745552
- OpenAlex
- W2120845288
- Cited by
- 287
- References
- 42
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 8 · 2020: 7 · 2019: 5 · 2018: 6 · 2017: 13 · 2016: 9 · 2015: 3 · 2014: 26 · 2013: 14 · 2012: 13
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Thorax (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- chronic obstructive pulmonary disease, depression, depression prevalence, comorbidities, chronic disease, depression measurement, methodological quality
- MeSH terms
- Aged, Depressive Disorder, Forced Expiratory Volume, Humans, Lung Diseases, Obstructive, Middle Aged, Risk Factors, Vital Capacity, Prevalence, Case-Control Studies
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