Non-respiratory symptom dominance is associated with depression in patients with chronic obstructive pulmonary disease
Non-respiratory symptom dominance is associated with depression in patients with chronic obstructive pulmonary disease
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非呼吸系统症状主导与慢性阻塞性肺疾病患者抑郁相关
DOI：
10.1016/j.rmed.2022.106895
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发表时间：
2022
影响因子：
4.3
通讯作者：
Hirai T.
中科院分区：
文献类型：
--
作者：
Hamakawa Y;Sato S;Tanabe N;Rhee C K;Jung K-S;Yoo K H;Tanimura K;Muro S;Hirai T.
抑郁症是慢性阻塞性肺疾病(COPD)患者常见而重要的合并症。抑郁状态与COPD评估测试(CAT)总分高有关，但很难区分抑郁症患者和严重症状性COPD患者。我们假设以非呼吸道症状为主的CAT评分升高与COPD患者的抑郁有关。方法分析了日本京都队列中的226名患者和韩国COPD亚组研究(KOCOSS)队列中的924名患者。抑郁症的诊断是基于京都队列中的PHQ-9(患者健康问卷-9)≥5和KOCOSS队列中的BDI-II(贝克抑郁问卷-II)≥17。结果京都队列中53例(23.5%)患者和KOCOSS队列中111例(11.2%)患者存在抑郁。京都队列中55名患者(24.3%)和KOCOSS队列中249名患者(26.9%)表现为非呼吸系统症状显性(Q1234≤Q5678)，他们的抑郁患病率显著高于呼吸系统症状显性患者(Q1234和Q5678)。多因素Logistic回归分析显示，在两组队列中，CAT总分和Q1234≤Q5678均与抑郁显著相关。此外，即使在有症状的患者中(CAT总分≥为10)，这些显著的关联也被保留了下来。结论CAT的非呼吸道症状主导是慢性阻塞性肺疾病患者抑郁的可疑特征。
IntroductionDepression is a common and important comorbidity in patients with chronic obstructive pulmonary disease (COPD). Depressive status is associated with a high COPD assessment test (CAT) total score, but it is difficult to distinguish patients with depression from those with severe symptomatic COPD. We hypothesized that a non-respiratory symptom-dominant elevation in CAT score is associated with depression in patients with COPD.MethodsA total of 226 patients in the KYOTO cohort in Japan and 924 patients in the Korea COPD Subgroup Study (KOCOSS) cohort in the Republic of Korea were analyzed. Depression was diagnosed based on a PHQ-9 (patient health questionnaire-9) ≥5 in the KYOTO cohort and a BDI-II (Beck Depression Inventory-II) ≥17 in the KOCOSS cohort. Sums of respiratory symptoms (Q1-Q4; Q1234) and non-respiratory symptoms (Q5-Q8; Q5678) from CAT items were analyzed.ResultsFifty-three (23.5%) patients in the KYOTO cohort and 111 (11.2%) patients in the KOCOSS cohort were identified as having depression. Fifty-five patients (24.3%) in the KYOTO cohort and 249 patients (26.9%) in the KOCOSS cohort showed non-respiratory symptom dominance (Q1234 ≤ Q5678), and they had a significantly higher prevalence of depression than did patients with respiratory symptom dominance (Q1234 > Q5678). Multivariable logistic regression analysis showed that both the CAT total score and Q1234 ≤ Q5678 were significantly associated with depression in both cohorts. Moreover, even in symptomatic patients (CAT total score ≥10), these significant associations were preserved.ConclusionNon-respiratory symptom dominance in CAT is a suspicious feature for depression in patients with COPD.