Prevalence of sub-threshold depression in elderly patients with chronic obstructive pulmonary disease

Objectives We hypothesized that COPD patients with sub‐threshold depression would have levels of disability and impaired quality of life approaching that for major depression and significantly greater than for non‐depressed COPD patients. Setting A university teaching hospital Method 137 outpatients (69 men), with a mean age of 73 years (range 60–89 years) with symptomatic irreversible, moderate to severe COPD were recruited. Subjects were interviewed using the Geriatric Mental State Schedule (GMS), a structured psychiatric interview schedule, along with its diagnostic algorithm AGECAT. A GMS/AGECAT score of 3 or more is indicative of a case‐level of depression, a GMS/AGECAT score of 1–2 indicates sub‐threshold depression and GMS/AGECAT of 0, no depression. Physical disability was measured by the Manchester Respiratory Activities of Daily Living questionnaire (MRADL) and quality of life was assessed by the Breathing Problems Questionnaire (BPQ). Results Mean (SD) one second forced expiratory volume was 0.89 (0.33) litres. The prevalence of GMS/AGECAT case‐level depression (≥ 3) was 57 cases (42%); of GMS/AGECAT sub‐threshold depression (1–2) 34 (25%); and GMS/AGECAT non‐depression (0) 46 (33%). Comparison of MRADL score in the three groups (mean, 95% confidence intervals) revealed [GMS ≥ 3 = 9.9 (8.4 to 11.3) vs GMS = 1–2, 12.9 (11.2 to 14.4) vs GMS = 0, 15.6 (14 to 16.6) p