If they are depressed, people with chronic obstructive pulmonary disease or COPD are at increased risk of dying over the next few years - even when their lung disease is relatively stable - according Dutch researchers.

COPD covers chronic lung conditions such as emphysema or chronic bronchitis. Jacob N. de Voogd, at University Medical Center Groningen, and colleagues studied the association between COPD and depression in 121 consecutive patients who were undergoing pulmonary rehabilitation.

As explained in the medical journal Chest, the subjects had been clinically stable for at least 6 weeks and did not require an increase in medication or hospitalization. A standard assessment was used to document significant depressive symptoms.

The patients were followed for up to nine years, during which time 76 of them died. The investigators found that the presence of depressive symptoms nearly doubled the likelihood of dying from any cause, regardless of gender, older age, and lower exercise capacity.

De Voogd’s group suggests that one reason for the association may be that depression interferes with self-care. Depressed patients are more likely to have an inadequate diet, to continue smoking, be less active, not take medication as prescribed, and to postpone needed health care.

Further research is needed, they conclude, to see if interventions such as psychotherapy and antidepressant treatment improve the outlook for people with COPD.

SOURCE: Chest, March 2009.