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Persistence of Depressive Symptoms in Patients With COPD: A 3-Year Longitudinal Follow-up Analysis of the ECLIPSE Study Cohort FREE TO VIEW

Abebaw Yohannes, PhD; Hana Mülerova, PhD; Hao Li; Nicola Hanania; Kim Lavoie; Ruth Tal-Singer; Jorgen Vestbo; Emiel Wouters
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Health Professions, Manchester Metropolitan University, Manchester, Greater Manchester, United Kingdom

Chest. 2014;146(4_MeetingAbstracts):33A. doi:10.1378/chest.1978679
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SESSION TITLE: COPD Diagnosis and Evaluation Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Depressive symptoms are common in patients with COPD. They are related with impaired quality of life, decreased physical activity and higher health-care utilization. Identifying risk factors of persistent of depression may help clinicians in targeting interventions in high risk population.

METHODS: We analyzed prospective cohort of COPD patients participating in the ECLIPSE. Depression was defined using the Epidemiologic Studies Depression Scale (CES-D) score (≥16) and antidepressant [AD] use. Patients with complete baseline (BL) and 3-year follow-up (3Y) were split into 4 groups: never depressed, new onset, remittent and persistent depression. Logistic regression was used to assess factors (clinical characteristics at BL) associated with persistent depression (CES-D ≥16 or AD use at BL and 3Y) group.

RESULTS: 1580 COPD patients completed the follow-up study. Out of these, 17% (N=368) were determined as persistently depressed. Predictors of persistent depression (CESD≥16 or antidepressant use at baseline and 3-years) are shown in the Table. Variables Odds ratio 95% confidence interval P-value Gender (female) 2.56 1.86-3.52 <0.0001 CESD score at BL per 1 unit worsening 1.18 1.15-1.21 <0.0001 Reversibility (FEV1) per 1% increase 1.01 1.00-1.03 <0.002 Higher SGRQ at BL per 4 units worsening 1.06 1.02-1.11 <0.003 CCL18/PARC per 1 log SD increase 1.02 1.02-1.04 <0.008 History of stroke 3.68 1.78-7.62 <0.0004

CONCLUSIONS: About one fifths of COPD patients remained with a persistent course of depressive symptoms over the 3-years. Females, in patients with reversibility in FEV1, higher baseline depressive symptoms and poorer health status, higher levels of CCL18/PARC and history of stroke were predictors of persistent depression after 3 years baseline assessment.

CLINICAL IMPLICATIONS: Clinician should be aware of the characteristics of persistent depressive symptoms; there is a need to develop targeted management strategies with long-term effectiveness evaluation.

DISCLOSURE: The following authors have nothing to disclose: Abebaw Yohannes, Hana Mülerova, Hao Li, Nicola Hanania, Kim Lavoie, Ruth Tal-Singer, Jorgen Vestbo, Emiel Wouters

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