More evidence that depressive symptoms predict mortality in COPD patients: is type D personality an alternative explanation?
OBJECTIVE
The present study attempted to replicate our previous finding that depressive symptoms are a risk factor for mortality in stable chronic obstructive pulmonary disease (COPD), but in a different population with a different measure of depressive symptoms. We further investigated whether type D personality is associated with mortality in patients with COPD and whether it explains any relationship observed between depressive symptoms and mortality.


METHODS
In 122 COPD patients, mean age 60.8 +/- 10.3 years, 52% female, and mean forced expiratory volume in 1 s (FEV(1)) 41.1 +/- 17.6%pred, we assessed body mass index, post bronchodilator FEV(1), exercise capacity, depressive symptoms with the Hospital Anxiety and Depression Scale, and type D with the Type D Scale.


RESULTS
In the 7 years follow-up, 48 (39%) deaths occurred. The median survival time was 5.3 years. Depressive symptoms (hazard ratio = 1.07, 95% confidence intervals = 1.00-1.14) were an independent risk factor for mortality. Type D was not associated with mortality.


CONCLUSIONS
We can rule out type D as an explanation for the relationship between depressive symptoms and mortality observed in this sample. However, ambiguity remains as to the interpretation of the value of depressive symptoms in predicting death.
de Voogd
Jacob N
JN
Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, The Netherlands. j.n.de.voogd@cvr.umcg.nl
Wempe
Johan B
JB
Postema
Klaas
K
van Sonderen
Eric
E
Ranchor
Adelita V
AV
Coyne
James C
JC
Sanderman
Robbert
R
D000368:Aged; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010551:Personality / Q000502:physiology*; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors