COPD and Depressive Symptoms: Findings from the Guangzhou Biobank Cohort Study
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ORIGINAL ARTICLE
COPD and Depressive Symptoms: Findings from the Guangzhou Biobank Cohort Study Adrian Loerbroks, Ph.D. & Chao Qiang Jiang, M.D. & G. Neil Thomas, Ph.D. & Peymané Adab, M.D. & Wei Sen Zhang, M.D. & Kin-bong Hubert Lam, Ph.D. & Jos A. Bosch, Ph.D. & Kar Keung Cheng, Ph.D. & Tai Hing Lam, M.D. Published online: 3 July 2012 # The Society of Behavioral Medicine 2012
Abstract Background Chronic obstructive pulmonary disease (COPD) co-exists with depression, but important questions remain about the determinants of this association. Purpose We examined the association of depressive symptoms with three aspects of COPD: self-reports of physician-diagnosed COPD, chronic respiratory symptoms, and airway obstruction. A. Loerbroks : J. A. Bosch Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany A. Loerbroks Cluster of Excellence “Asia and Europe in a Global Context”, Heidelberg University, Heidelberg, Germany C. Q. Jiang : W. S. Zhang Guangzhou No.12 People’s Hospital, Guangzhou, People’s Republic of China G. N. Thomas : P. Adab (*) : K. K. Cheng Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK e-mail: [email protected] K.-b. H. Lam Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK J. A. Bosch School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK T. H. Lam School of Public Health, University of Hong Kong, Pokfulam, Hong Kong, China
Methods We used data from the Guangzhou Biobank Cohort Study (n07,995). Airway obstruction was assessed by spirometry. A score ≥4 on the 15-item Geriatric Depression Scale was used as a cutoff for depressive symptoms. Results Self-reported COPD was positively associated with depressive symptoms but airway obstruction was not. Compared to those free of both respiratory symptoms and airway obstruction those reporting respiratory symptoms were more likely to have depressive symptoms regardless of whether they had obstruction or not. Conclusions In this Chinese population, a self-reported physician diagnosis of COPD and symptom perception, but not airway obstruction, appeared as main determinants of depressive symptoms. Keywords Airway obstruction . COPD . Depression . Epidemiology . Respiratory symptoms . China
Introduction Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality and is projected to rank third among the leading causes of death worldwide by 2020 [1]. While COPD is a major public health concern in Western countries, it is an even greater challenge to Asian societies in terms of the burden of disease (e.g., a higher prevalence and many years spent living with disability) and the associated total number of deaths [2, 3]. This is a particularly serious problem in the world’s most populous country, China [4], which has more than 38 million COPD pat
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