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LetterCorrespondence

Depression in Japanese Patients With COPD: A Cross-Sectional Study

Samer Alkhuja
Respiratory Care December 2013, 58 (12) e172; DOI: https://doi.org/10.4187/respcare.02855
Samer Alkhuja
Commonwealth Medical College Pocono Medical Center East Stroudsburg, Pennsylvania
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To the editor:

I read the study by Horita et al “Depression in Japanese Patients With COPD: A Cross-Sectional Study,”1 in which the severity and prevalence of depression were found to be associated with the severity and other parameters of COPD.1

In addition to the COPD parameters, obstructive sleep apnea (OSA) should be added as a risk factor for depression. The comorbid association of COPD and OSA is called the “overlap syndrome.”2 Chen et al evaluated 2,818 patients diagnosed with OSA, and 14,090 matched non-OSA enrollees used as a comparison cohort.3 The reported incidence of depression per thousand person-years was about twice as high among patients with OSA as those without OSA.3 Furthermore, Best et al studied 82 out-patients with treatment-resistant depression who underwent overnight polysomnography, and found that many individuals with treatment-resistant depression have OSA.4

The effect of CPAP treatment on depression was evaluated by Diamanti et al, in 24 patients with depression and OSA, who were followed for at least 6 months after initiation of CPAP.5 CPAP improved quality of life and decreased depression symptoms.5 In a similar study, El-Sherbini et al explored the effect of CPAP in 37 patients with depression and OSA, before and 2 months after initiating CPAP.6 Their findings suggested that patients with OSA should be screened for depression, and that CPAP should be tried first, before other depression therapies.6

COPD, overlap syndrome, and depression are intertwined. When evaluating depression in patients with COPD, screening for OSA should be performed, and CPAP treatment, if indicated, should follow. This approach may improve the control of depression in patients with COPD.

Footnotes

  • The author has disclosed no conflicts of interest.

  • Copyright © 2013 by Daedalus Enterprises

References

  1. 1.↵
    1. Horita N,
    2. Kaneko T,
    3. Shinkai M,
    4. Yomota M,
    5. Morita S,
    6. Rubin BK,
    7. Ishigatsubo Y
    . Depression in Japanese patients with chronic obstructive pulmonary disease: a cross-sectional study. Respir Care 2013;58(7):1196-1203.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Lee R,
    2. McNicholas WT
    . Obstructive sleep apnea in chronic obstructive pulmonary disease patients. Curr Opin Pulm Med 2011;17(2):79-83.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Chen YH,
    2. Keller JK,
    3. Kang JH,
    4. Hsieh HJ,
    5. Lin HC
    . Obstructive sleep apnea and the subsequent risk of depressive disorder: a population based follow-up study. J Clin Sleep Med 2013;9(5):417-423.
    OpenUrlPubMed
  4. 4.↵
    1. Best MW,
    2. Fitzpatrick M,
    3. Milev R,
    4. Bowie CR,
    5. Jokic R
    . Utility of the Berlin questionnaire for predicting obstructive sleep apnea in individuals with treatment-resistant depression. Sleep Breath 2013 [Epub ahead of print].
  5. 5.↵
    1. Diamanti C,
    2. Manali E,
    3. Ginieri-Coccossis M,
    4. Vougas K,
    5. Cholidou K,
    6. Markozannes E,
    7. et al
    . Depression, physical activity, energy consumption, and quality of life in OSA patients before and after CPAP treatment. Sleep Breath 2013 [Epub ahead of print].
  6. 6.↵
    1. El-Sherbini AM,
    2. Bediwy AS,
    3. El-Mitwalli A
    . Association between obstructive sleep apnea and depression and the effect of continuous positive airway pressure treatment. Neuropsychiatry Dis Treat 2011;7(1):715-721.
    OpenUrl
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Respiratory Care: 58 (12)
Respiratory Care
Vol. 58, Issue 12
1 Dec 2013
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Depression in Japanese Patients With COPD: A Cross-Sectional Study
Samer Alkhuja
Respiratory Care Dec 2013, 58 (12) e172; DOI: 10.4187/respcare.02855

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Depression in Japanese Patients With COPD: A Cross-Sectional Study
Samer Alkhuja
Respiratory Care Dec 2013, 58 (12) e172; DOI: 10.4187/respcare.02855
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