Incidence of depression and antidepressant prescription in patients with COPD: A large UK population-based cohort study. (May 2022)

• Record Type: Journal Article
• Authors: Siraj, R.A.; McKeever, T.M.; Gibson, J.E.; Bolton, C.E.
• Is Part Of: Respiratory medicine. Volume 196(2022)
• Publication Date: 2022-05
• Subjects: COPD -- Depression -- Mental health -- Antidepressant; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2022.106804
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: Depression is frequently reported in patients with Chronic Obstructive Pulmonary Disease (COPD). However, there is little information available on the incidence of depression following a COPD diagnosis. Objective: To determine the incidence of a new diagnosis of depression or antidepressant prescription in people with and without a COPD diagnosis. Methods: A matched cohort study was conducted using The Health Improvement Network database. Patients with confirmed COPD diagnosis were matched to up to four subjects without a COPD diagnosis by age, sex and GP practice. Cox proportional hazards models were used to assess the incidence rates of depression and antidepressant prescription. Results: 44, 362 patients with COPD and 124, 140 subjects without COPD were included. The incidence rate of depression per 1000 person-years following COPD diagnosis was greater (11.4; 95% CI: 10.9–11.8) compared to subjects without COPD (5.7; 95% CI: 5.5–5.8) (p < 0.001). Patients with COPD were 42% more likely to have an incident depression (adjusted hazard ratio [aHR]: 1.42; 95% CI: 1.32–1.53; p < 0.001), and 40% more likely to be prescribed an antidepressant (aHR: 1.40; 95% CI: 1.35–1.45; p < 0.001). The incidence to either depression or antidepressant prescription was also greater for patients with COPD (aHR: 1.41; 95% CI: 1.36–1.46; p < 0.001). Patients with COPD and worse breathlessness had a higher risk of incident depression compared to patients with less breathlessness. Conclusion: Healthcare providers managing patients with COPD should be alert to the existence of depression and aware of its symptoms and consequences. Highlights: ∙ Depression is among the common comorbidities in patients with COPD, yet has not been well studied. ∙The incidence of depression and antidepressant prescriptions are greater in patients with COPD than those without. ∙Healthcare professionals should be vigilant to symptoms and target accordingly.