Predictors of Depressive Symptoms in Patients with COPD and Health Impact

Figures & data

Table 1 Distribution of categorical characteristics of 207 patients with COPD

Characteristic	Total %	CES-D ≥ 16%	Odds Ratio (95% CI)
Age (years)
45–64	22.7	66.0	Reference
65–74	53.1	62.7	0.87 (0.40, 1.88)
≥75	24.2	48.0	0.48 (0.19, 1.17)
Gender
Male	44.9	57.0	Reference
Female	55.1	63.2	1.29 (0.71, 2.35)
Race
White	87.9	61.3	Reference
Black	12.1	52.0	0.68 (0.27, 1.71)
Marital status
Widowed	28.0	46.6	Reference
Married	46.9	62.9	1.95 (1.00, 3.77)
Separated/divorced	16.9	71.4	2.87 (1.17, 7.04)
Single	8.2	70.6	2.76 (0.86, 8.82)
Education
≥High school	58.9	53.3	Reference
< High school	41.1	70.6	2.10 (1.17–3.78)
Income
< 10,000	41.1	62.4	Reference
10,001–20,000	29.5	60.7	0.93 (0.45, 1.93)
20,001–30,000	17.8	54.1	0.71 (0.30, 1.67)
> 30,000	11.6	62.5	1.01 (0.71, 1.42)
Employment
Unemployed	89.3	60.3	Reference
Employed	10.7	63.6	1.15 (0.46, 2.88)
Smoking status
Former	64.3	55.6	Reference
Current	35.7	68.9	1.77 (0.97–3.22)
GOLD stage
II	37.9	56.4	Reference
III	40.3	61.5	1.23 (0.63, 2.43)
IV	21.8	64.4	1.40 (0.62, 3.20)
Chronic Conditions
None	5.3	36.4	Reference
≥1 LT	58.9	53.3	2.00 (0.56, 7.17)
≥1 non-LT	35.8	75.7	5.44 (1.43, 20.76)
Depression/Anxiety Medications
None	65.7	47.1	Reference
≥1	34.2	84.5	6.14 (2.83, 13.58)

*LT = life threatening.

Table 2 Mean values for characteristics of COPD patients (n = 207) with (CES-D ≥ 16) and without depressive symptoms

Characteristic	CES-D < 16	CES-D ≥ 16
	Mean (±SD)	Mean (±SD)
BMI	27.39 (6.03)	27.98 (6.23)
Self-efficacy
Negative affect	3.75 (1.01)	2.84 (0.87)^+
Emotional arousal	3.74 (0.99)	2.89 (0.92)^+
Physical exertion	2.75 (1.21)	1.99 (0.92)^+
Weather	3.25 (1.04)	2.50 (0.78)^+
Risk Factors	3.56 (1.18)	2.81 (0.98)^+
Social support
Tangible support	4.03 (1.09)	3.57 (1.12)^+
Affectionate	4.08 (1.18)	3.67 (1.27)^#
Social interaction	3.88 (1.11)	3.21 (1.23)^+
Emotional and informational	4.01 (1.03)	3.31 (1.17)^+
Illness intrusiveness	30.50 (14.41)	45.3 (17.16)^+

*BMI = body mass index (weight (kg)/height² (m)).

⁺ p < 0.01, ^# p < 0.05.

Table 3 Mean values for self-reported healthcare utilization during the previous 6 months among COPD patients with (CES-D ≥ 16) and without depressive symptoms

Characteristic	CES-D < 16	CES-D ≥ 16
	Mean (±SD)	Mean (±SD)
Healthcare Utilization for Lung Disease
Doctor visits	1.13 (1.67)	1.89 (3.65)
ER visits	0.17 (0.62)	0.28 (0.90)
Hospitalizations	0.06 (0.24)	0.27 (1.02)
Healthcare Utilization for Other Conditions
Doctor visits	3.24 (3.94)	3.38 (4.52)
ER visits	0.18 (0.50)	0.28 (0.59)
Hospitalizations	0.20 (0.64)	0.20 (0.47)

*p ≤ 0.05 (two sample t-tests were performed for each of the six comparisons).

Table 4 Incidence ratios (IR) for lung-related healthcare utilization during the previous 6 months among patients with COPD

Predictor	Doctor Visits	ER Visits	Hospitalizations
Characteristic	IR (95% CI)	IR (95% CI)	IR (95% CI)
CES-D ≥ 16	1.70 (1.02, 2.81)	1.76 (0.93, 3.34)	5.74 (2.02, 16.28)
Males	1.38 (0.87, 2.18)	1.35 (0.77, 2.40)	1.57 (0.82, 3.00)
Current Smoker	0.73 (0.43, 1.24)	0.98 (0.52, 1.84)	0.73 (0.35, 1.52)
Gold Stage
II	0.53 (0.29, 0.98)	0.22 (0.09, 0.54)	0.24 (0.10, 0.57)
III	0.79 (0.46, 1.35)	0.68 (0.37, 1.25)	0.32 (0.15, 0.68)
IV	Reference	Reference	Reference

*from Poisson Regression.