Debilitating symptoms from chronic obstructive pulmonary disease (COPD) can worsen in patients who also experience depression, research suggests.
A new study, published in CHEST Journal, demonstrates a link between an exacerbation of COPD in patients and depression.
Patients who had pre-existing depression or developed depression after COPD diagnosis were more likely to experience heightened COPD symptoms, such as increased breathlessness, reduced exercise tolerance and hopelessness.
Patients with the obstructive lung condition and depression also performed worse than COPD patients without depression in exercise tests, showing a pronounced loss in performance in their daily activities.
The results have implications for healthcare practitioners who could potentially screen for mental health problems periodically in those patients with a history of difficulty coping at home, poor adherence to therapy or experience of a recent bereavement, in a bid to reduce COPD-related hospital readmission.
Lead researcher Dr Abebaw Mengistu Yohannes, Reader at Manchester Metropolitan University, an expert in COPD and mental health, said: “We have found a previously unknown link between the brain and COPD. Mental health can have repercussions elsewhere in body, in this case, exacerbating the negative effects of COPD and poor prognosis in health outcomes.
“Essentially, we can treat the brain to treat the lungs and this is something health practitioners should be aware of when working with COPD patients.
“It creates a strong argument for vigorous screening of mental health problems in patients who are admitted in the short term for exacerbations of COPD. Managing mental health problems associated with COPD should be an important part of the management plan for the short term as well as the discharge planning with longer-term follow-up.”
The research looked at 1,589 patients over a three-year period. It found that more than half did not experience any depressive symptoms. Almost a quarter of COPD patients were classified as permanently depressed while 14 per cent developed a ‘case’ for depression during the three-year follow-up.
COPD patients were asked to complete a six-minute walking test and quality of life scale. Those with depression performed worse in exercise tolerance and impaired quality of life than COPD patients without depression. Researchers concluded that depression in COPD is chronic and inadequately treated.
The paper, Long-term Course of Depression Trajectories in Patients With COPD: A 3-Year Follow-up Analysis of the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints Cohort, was published in Chest. 2016 Apr;149(4):916-26. doi: 10.1016/j.chest.2015. http://www.ncbi.nlm.nih.gov/pubmed/26836938