ABSTRACT
Background & objectives: Although depression is a significant co-morbid condition in chronic illnesses, little is known about the prevalence or risk factors for depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) in India. This study was undertaken to investigate the presence and risk factors of depression in the COPD patients attending a tertiary care health facility in north India. Methods: COPD was classified according to GOLD stages based on forced expiratory volume in one second (FEV1) in 126 stable patients. Depression was examined by administering the nine-item Hindi version of Patient Health Questionnaire-9 (PHQ-9). Linear regression model was used to examine association between predictor variables and risk of depression with adjustment of age and sex. Cronbach alpha was calculated to assess internal consistency of PHQ-9. Results: In the study population as whole, 33.3 per cent patients showed moderate to severe depressive symptoms whereas 20.6 per cent patients had major depressive disorder on PHQ-9 Scale. Educational and occupational status, body mass index, FEV1, respiratory symptoms, physical impairment and dyspnoea were found to be potential predictors of depression in COPD patients. Interpretation & conclusions: One fifth of the patients with COPD had severe symptoms of related to depression, which was especially higher with severity of COPD. Hence, the patients with COPD should focus on management of these two conditions. Further, future studies should be conducted to assess the role of depression management and timely treatment of it in patients with COPD.
ABSTRACT
Background & objectives: Although depression is a significant co-morbid condition in chronic illnesses, little is known about the prevalence or risk factors for depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) in India. This study was undertaken to investigate the presence and risk factors of depression in the COPD patients attending a tertiary care health facility in north India. Methods: COPD was classified according to GOLD stages based on forced expiratory volume in one second (FEV1) in 126 stable patients. Depression was examined by administering the nine-item Hindi version of Patient Health Questionnaire-9 (PHQ-9). Linear regression model was used to examine association between predictor variables and risk of depression with adjustment of age and sex. Cronbach alpha was calculated to assess internal consistency of PHQ-9. Results: In the study population as whole, 33.3 per cent patients showed moderate to severe depressive symptoms whereas 20.6 per cent patients had major depressive disorder on PHQ-9 Scale. Educational and occupational status, body mass index, FEV1, respiratory symptoms, physical impairment and dyspnoea were found to be potential predictors of depression in COPD patients. Interpretation & conclusions: One fifth of the patients with COPD had severe symptoms of related to depression, which was especially higher with severity of COPD. Hence, the patients with COPD should focus on management of these two conditions. Further, future studies should be conducted to assess the role of depression management and timely treatment of it in patients with COPD.
ABSTRACT
Background & objectives: Depression is common among people with diabetes and it is associated with poor outcomes. This study was carried out to investigate the prevalence and determinants of depression in patients with established type 2 diabetes (T2DM) attending a tertiary care hospital in north India. Methods: Patients with established T2DM were evaluated for depression by administering the nine-item PHQ-9 (Hindi version). Binary logistic regression model was used to examine association between predictor variables and risk of depression. Results were expressed as odds ratio and 95 per cent confidence interval. Cronbach alpha was calculated to assess internal consistency of PHQ-9. Results: Patients with T2DM (n=300) were evaluated [147(49%) male and 153(51%) female]. The median duration of diabetes (IQ) was 8(4-13) yrs. Of the study patients, 68 (23%) met the criteria for major depression, 54 (18%) for moderate depression and the remaining 178 (59%) had no clinically significant depression. Depression was strongly associated with age >54 yr (OR 1.26, 95% CI 1.02-1.67; P<0.05), central obesity (OR 1.34, 95% CI 1.04-1.64; P<0.001), neuropathy (OR 1.94, 95% CI 1.03-3.66; P=0.002), nephropathy (OR 1.81, 95% CI 1.02-3.21; P=0.041), peripheral vascular disease (OR 6.08, 95% CI 1.07-34.6; P=0.042), diabetic foot disease (OR 2.32, 95% CI 1.06-5.86; P<0.001) and pill burden (>4) (OR 1.27, 95%CI 1.01-1.44; P=0.035 ). However, the likelihood of depression was not significant with duration of diabetes and insulin use. Interpretation & conclusion: This study showed high prevalence of depression in patients with T2DM. The risk factors for depression were age, central obesity, diabetic complications particularly neuropathy and diabetic foot disease and increased pill burden.