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Original Research |

The Risk for Depression Comorbidity in Patients With COPD

Lisette van den Bemt, MSc*; Tjard Schermer, PhD; Hans Bor; Renate Smink, MD; Evelyn van Weel-Baumgarten, MD, PhD; Peter Lucassen, MD, PhD; Chris van Weel, MD, PhD
Author and Funding Information

*From the Department of General Practice (Ms. van den Bemt, Mr. Bor, and Drs. Schermer, van Weel-Baumgarten, Lucassen, and van Weel) and Nursing Home Department (Dr. Smink), Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.

Correspondence to: Lisette van den Bemt, MSc, Radboud University Nijmegen Medical Centre, Department of General Practice, (117) PO Box 9101, 6500 HB Nijmegen, the Netherlands; e-mail: L.vandenbemt@hag.umcn.nl

*Data are presented as No. (%), mean ± SD, or median (25th–75th percentile).

†p ≤ 0.01 for difference with COPD group.

‡For COPD and DM: time from diagnosis of chronic condition (ie, COPD or DM) until diagnosis of first depression. For control subjects: start of observation time until first diagnosis of depression.

*Data are presented as HR (95% CI).

†p ≤ 0.01.

‡Reference group: general practice 1.

§Reference group: low SES.

Ms. van den Bemt has no conflicts of interest to disclose. Dr. Schermer received grant money for research in the field of respiratory medicine from noncommercial organizations (Radboud University Nijmegen Medical Centre, the Netherlands Organization for Health Research and Development [ZonMw], and the Dutch Asthma Foundation), and from several pharmaceutical companies (Boehringer Ingelheim, AstraZeneca, and GlaxoSmithKline); Mr. Bor, Dr. Smink, and Dr. van Weel-Baumgarten have no conflicts of interest to disclose. Dr. van Weel's Department of General Practice, Radboud University Nijmegen Medical Centre, has received financial support for research from the university and unrestricted grants for research and education from the pharmaceutical industry.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Ms. van den Bemt has no conflicts of interest to disclose. Dr. Schermer received grant money for research in the field of respiratory medicine from noncommercial organizations (Radboud University Nijmegen Medical Centre, the Netherlands Organization for Health Research and Development [ZonMw], and the Dutch Asthma Foundation), and from several pharmaceutical companies (Boehringer Ingelheim, AstraZeneca, and GlaxoSmithKline); Mr. Bor, Dr. Smink, and Dr. van Weel-Baumgarten have no conflicts of interest to disclose. Dr. van Weel's Department of General Practice, Radboud University Nijmegen Medical Centre, has received financial support for research from the university and unrestricted grants for research and education from the pharmaceutical industry.

Ms. van den Bemt has no conflicts of interest to disclose. Dr. Schermer received grant money for research in the field of respiratory medicine from noncommercial organizations (Radboud University Nijmegen Medical Centre, the Netherlands Organization for Health Research and Development [ZonMw], and the Dutch Asthma Foundation), and from several pharmaceutical companies (Boehringer Ingelheim, AstraZeneca, and GlaxoSmithKline); Mr. Bor, Dr. Smink, and Dr. van Weel-Baumgarten have no conflicts of interest to disclose. Dr. van Weel's Department of General Practice, Radboud University Nijmegen Medical Centre, has received financial support for research from the university and unrestricted grants for research and education from the pharmaceutical industry.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(1):108-114. doi:10.1378/chest.08-0965
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Introduction:  Patients with COPD are believed to have a high risk for the development of depression. However, it remains unclear whether or not there is a temporal relation between COPD and depression, and if the higher risk for depression is a result of having a chronic disease, or is specific for COPD. The aim of this study is to compare the risk for physician-diagnosed depression in patients with COPD, patients with diabetes mellitus (DM), and control subjects without chronic conditions.

Methods:  The study was a prospective cohort study based on the Continuous Morbidity Registration database. Cox proportional hazards analysis was used to identify the risk of a first episode of depression in patients with COPD compared to patients with DM and matched control subjects without chronic conditions. The following covariates were added to the model: age, the general practice the patient was listed with, socioeconomic status, comorbidity, and gender. All patients with a diagnosis of depression preceding the date of first diagnosis of COPD or DM (dummy date in control subjects) were excluded.

Results:  The hazard ratios for a first episode of depression in the COPD group compared to the DM group and healthy controls subjects were 1.80 (95% confidence interval [CI], 1.16 to 2.81) and 1.68 (95% CI, 1.20 to 2.35), respectively.

Discussion:  We found a temporal relation between COPD and physician-diagnosed depression. Patients with COPD are more likely to have depression diagnosed than patients with DM and control subjects without chronic conditions.

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