title: Factors associated with depression and severe depression in patients with COPD.
abstract: BACKGROUND
  Depression is very prevalent in COPD and may be associated with poor clinical outcomes.
  
  
  METHODS
  This was a multicenter, cross-sectional study aimed at evaluating the prevalence of depression and moderate to severe depression in COPD. Depressive symptoms were evaluated with the Beck's Depression Inventory. The COPD assessment test (CAT) and the EuroQoL-5 dimensions (EQ-5D) questionnaires were used to evaluate health-related quality of life (HRQoL). Severity of COPD was assessed with the BODEx index and physical activity was estimated by the mean self-declared time walked per day.
  
  
  RESULTS
  A total of 836 patients were included and up to 74.6% had some degree of depression with 51.5% having moderate to severe depression. On multivariate analysis, moderate to severe depression was associated with suicidal ideation (OR, 6.12; 95% confidence interval (CI), 1.36-28.24), worse quality of life: EQ-5D (OR, 0.89; 95%CI, 0.86-0.93) and worse CAT scores (OR, 1.32; 95%CI, 1.19-1.46). When questionnaires were not included in the analysis, significant depression was associated with the Charlson comorbidity index, minutes walked per day and BODEx score.
  
  
  CONCLUSIONS
  Depression is frequent in COPD and is associated with suicidal ideation, impaired HRQoL, increase in comorbidities, a reduction in physical activity and increased severity of COPD measured by the BODEx index.
authors.affiliation: Department of Pneumology, Hospital Universitari Vall d'Hebron, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. Electronic address: mmiravitlles@vhebron.net.
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
authors.affiliation: Centro de Salud Francia, Dirección Asistencial Oeste, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Molina
authors.affiliation: Centro de Salud Lucena I, Lucena, Córdoba, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Quintano
authors.affiliation: Medical Department Grupo Ferrer, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Campuzano
authors.affiliation: Medical Department Grupo Ferrer, Barcelona, Spain.
authors.forename: Joselín
authors.initials: J
authors.lastname: Pérez
authors.affiliation: Outpatient Drug Clinic (CAS) Vall d'Hebron, Psychiatry Department, Vall d'Hebron Hospital-ASPB, Ciber de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autónoma de Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Roncero
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
keywords: Beck's depression inventory; COPD; Depression; Physical activity; Quality of life