title: More evidence that depressive symptoms predict mortality in COPD patients: is type D personality an alternative explanation?
abstract: 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.
authors.affiliation: Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, The Netherlands. j.n.de.voogd@cvr.umcg.nl
authors.forename: Jacob N
authors.initials: JN
authors.lastname: de Voogd
authors.forename: Johan B
authors.initials: JB
authors.lastname: Wempe
authors.forename: Klaas
authors.initials: K
authors.lastname: Postema
authors.forename: Eric
authors.initials: E
authors.lastname: van Sonderen
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
authors.forename: James C
authors.initials: JC
authors.lastname: Coyne
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
mesh_terms: 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