Abstract
Chronic obstructive pulmonary disease (COPD) is a disorder leading to physical and mental impairment. Aim of the present study was to evaluate the effect of BODE index and its components on depressive symptoms and Quality of Life (QoL). We studied 37 consecutive COPD outpatients (26 M, aged 53-86 years). COPD diagnosis was confirmed by clinical and functional assessment. The patients were classified on the basis of GOLD and BODE stages. QoL was assessed by SF-36 questionnaire through its two components: Physical Health (PCS) and Mental Health (MCS). Depressive symptoms were assessed by the Beck Depression Inventory-II (BDI-II). 14 patients were allocated in GOLD stage I, 18 in II, and 5 in III. No patient was in GOLD stage IV. BODE index ranged 0-6. Median depression value (IQ range) was 7 (4-11). 23 subjects did not present depressive symptoms, 8 showed mild depression, and 6 moderate depression. None showed severe depression. Mean PCS and MCS were 46.4 (±10.4) and 47.5 (±9.6) respectively. PCS and MCS values lower respect to mean value of Italian general population were found in 22 and 17 subjects, respectively. A negative relationship was found between BDI-II and PCS (p=0.02). BDI-II was linearly correlated to BODE (p<0.0001) but not to GOLD stage. PCS was inversely correlated to BODE (p=0.02), but not to GOLD Stage. MCS was not correlatet to BODE and to GOLD Stage. Among individual components of BODE, only MRC was a good and direct predictor for depression (p=.007), and an inverse predictor for both MCS (p=.007) and PCS (p=.0002). In conclusion, a greater dyspnea perception, regardless of disease severity, is associated with higher depression score and poorer QoL.
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