Dr. Mathan K


Patients suffering from chronic medical illnesses like COPD are reported to have psychiatric disorders like depression and anxiety. Though the prevalence of COPD is high in Indian population, there are very few studies regarding the presence of depressive disorders in patients with COPD. Knowing the prevalence of depressive disorders is important in offering holistic treatment for these patients. In this study 131 subjects with chronic respiratory disease were recruited through purposive sampling and was screened using MINI - International Neuropsychiatric Interview Scale. Those diagnosed with depression were further evaluated using HAMD for severity of depression. The results were analyzed using chi square test. Analysis showed that 64.1% of the patients had depressive disorders. Significant higher prevalence of depressive disorder was noted in patients belonging to older age, illiterates and among low socioeconomic Stata. Severity of Depressive disorders increased with duration of illness, number of hospitalizations, use of steroid drugs


COPD, psychiatric morbidity, depression,

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Salvi S. COPD: The neglected epidemic. Textbook of Pulmonary and Critical Care Med Vol 2, Ed: Jindal SK, Jaypee Publications, 2011; 971-974.

Lopez A, Shibuya K, Rao C Chronic obstructive Pulmonary Disease: Current burden and future projections. Eur Respir J 2006; 27:397-412.

American Thoracic Society: Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995; 152, S77-S121.

World Health Organization: The GOLD global strategy for the management and prevention of COPD. 2001Available at: Accessed on March 16.

Siafakas, NM, Vermeire, P, Pride, NB, et al Optimal assessment and management of chronic obstructive pulmonary disease(COPD): the European Respiratory Society Task Force. Eur Respir J 1995; 8, 1398-1420

Murthy KJR, Sastry JG. Economic burden of chronic obstructive pulmonary disease: NCMH Background Papers- Burden of Disease in India 2005.

Anderson D, Ferris BG Jr. Role of tobacco smoking in the causation of chronic respiratory disease. N Engl J Med 1962; 267:787–94.

Singh S, Soumya M, Saini A, Mittal V, Singh UV, Singh V. Breath carbon monoxide levels in different forms of smoking. Indian J Chest Dis Allied Sci 2011; 53:25-28.

Salvi S, Barnes PJ. Is exposure to biomass smoke the biggest risk factor for COPD globally? Chest 2010; 138:3-6.

Salvi SS, Barnes P: Chronic obstructive pulmonary disease in nonsmokers. Lancet 2009; 374:733-743.

Liu W, Zhang J, Hashim JH, Jalaludin J, Hashim Z, Goldstein BD. Mosquito coil emissions and health implications. Environ Health Perspect 2003; 111:1454-1460.

Snider GL, Doctor L, Demas TA, Shaw AR. Obstructive airway disease in patients with treated pulmonary tuberculosis. Am Rev Respir Dis 1971; 103:625–640.

Limaye S, Salvi S. Risk factors for COPD: Textbook of Pulmonary and Critical Care Med Vo 2, Ed: Jindal SK, Jaypee Publications, 2011; 987-992.

Health Status Maharashtra 2009: A report by the State Health Systems Resource Centre, 2010; 20-

Carlin BW et al .COPD and associated comorbidities: a review of current diagnosis and treatment. Postgrad Med. 2012 Jul; 124(4):225-40.

Pauwels R et al .Global initiative for chronic obstructive lung diseases (GOLD): time to act. Eur Respir J. 2001 Dec; 18(6):901-2. . Murray CJ, Lopez AD et al. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of DiseaseStudy. Lancet. 1997 May 24; 349(9064):1498

Bakke P et al, Nutritional status and long-term mortality in hospitalised patients with chronic obstructive pulmonary disease (COPD). Respir Med. 2007 Sep; 101(9):1954-60. Epub 2007 May 25.

Lundbäck B et al,Epidemiological aspects and early detection of chronic obstructive airway diseases in the elderly.Eur Respir J Suppl. 2003 May; 40:3s-9s Review.

Siafakas et al: Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force. Eur Respir J. 1995 Aug; 8(8):1398-420.

Burge Set al: COPD exacerbations: definitions and classifications. Eur Respir J Suppl. 2003 Jun; 41:46s-53s.

Agusti AG et al, COPD, a multicomponent disease: implications for management. Respir Med. 2005 Jun;99(6):670-82. Epub 2005 Jan 8. Review.

Lindberg A et al ,Ten-year cumulative incidence of COPD and risk factors for incident disease in a symptomatic cohort.Chest. 2005 May;127(5):1544

Lindberg A et al , Prevalence and underdiagnosis of COPD by disease severity and the attributable fraction of smoking Report from the Obstructive Lung Disease in Northern Sweden Studies. Respir Med. 2006 Feb;100(2):264-72. Epub 2005 Jun 21. Erratum in: Respir Med. 2007 Dec;101(12):2569. Bjerg-Bäcklund, Anders [corrected to Bjerg, A].

American Psychiatric Association : Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision. Washington, DC, American Psychiatric Press, 2000.

Di Marco F, Verga M, Reggente M, et al. Anxiety and depression in COPD patients: The roles of gender and disease severity. Respir Med. 2006; 100(10):1767-1774.

Gudmundsson G, Gislason T, Janson C, et al. Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression. Eur Respir J. 2005; 26(3):414-419.

Stage KB, Middelboe T, Pisinger C. Depression and chronic obstructive pulmonary disease (COPD). Impact on survival. Acta Psychiatr Scand. 2005; 111(4):320-323.

Coffman K, Levenson JL. Lung disease. In: Levenson JL, ed. Essentials of Psychosomatic Medicine. Washington, DC: American Psychiatric Publishing; 2007:35-54.

World Health Organization; International classification of Mental and Behavioural Disorders, Tenth Revision (ICD-10), Geneva, 2002.

Gautam S.K.S., Kapur R.L., Psychiatric patients with somatic complaints, Ind J Psychiat. 1977; 19(4): 75-80.

Prakash R., Shethi B.B., Hypochondriacal Symptoms in Medical Patients and their psychiatric status, Ind J of Psychiat, 1978 ;20, 240-243.

Chaudhury A., Nandi D.N., An Association of Depression with a set of Medical Disorders, Ind J of Psychiat, 1979 ; 21, 224-227.

. Gurmeet singh et all .prevalence of depression in medical in patients (1979) . indian journal of psychiatry

Nikapota A.D., Patrick V., Fernando L.H.S., Aspects of psychiatric morbidity in the out patient population of a General Hospital in Sri Lanka, Ind J Psychiat, 1981 ; 23(3), 219-223.

. V. Ramachandran, socio-cultural factors in late onset depression , indian j. Psycfaat.(1982), 24(3), 268—273

Covino N.A, Dirks J.F, Kinsman R.A, Seidel J.V. Patterns of depression in chronic illness. Psychother Psychosom. 1982; 37(3): 144 - 53.

Vijoy K. Varma., Santhosh K. Chaturvedi, Anil Malhotra, Promilla hari.,Psychiatric Aspects of Chronic Intractable Pain, Ind J Psychiat, 1983; 25(3) 173-179.

Bagadia V.N., Ayyar K.S., Lakdawala P.D., Sheth S.M., Acharya V.N., Pradhan P.V., Psychiatric Morbidity among patients attending Medical Outpatient Department. Ind J Psychiat, 1986; 28(2),139-144.

Ebrahim Haroon A., Psychiatric Disturbances following stroke, Ind J Psychiat, 1986; 28(4), 335-341.

Sriram T.G., Shamasunder C., Mohan K.S., Shanmugham V., Psychiatric Morbidity in the Medical Outpatients of a General Hospital, Ind J Psychiat 1986 ; 28(4) 325-328.

Jaswant Singh Sachdeva., Shergill C.S., Sidhu B.S., Prevalence of Psychiatric Morbidity among Medical in-patients. Ind J Psychiat 1986; 28(4): 293-296.

Santhosh K. Chaturvedi, Albert Michael, S. Sarukaddam, Somatizers in Psychiatric Care, Ind J Psychiat 1987; 29(4) 337-342.

Mahendru R.K., Gupta A.K., Bahal D.K., Physical illness in psychiatric patients, Ind.J.Psychiat, 1987; 29(3), 269-273.

Yellowlees PM . The treatment of psychiatric disorders in patients with chronic airways obstruction. Med J Aust. 1987 Oct 5;147(7):349-52.

Gift AG, Wood RM, Cahill CA. Depression, somatization and steroid use in chronic obstructive pulmonary disease. Int J NursStud 1989;26:281_/6.

David H. Strauss., Robert L. Spitzer. and Philip R. Muskin. Maladaptive Denial of Physical Illness: A Proposal for DSM-IV, Am J Psychiat 1990; 147:9

Fulop G. Anxiety disorders in the general hospital setting. Psychiatr Med. 1990 ; 8(3): 187 - 95

. Constant P , The Influence of an Inhaled Steroid on Quality of Life in Patients With Asthma or COPD ,CHEST.1995;107(5):1199:10.1378/chest.107.5.1199

Silverstone P.H. Prevalence of Psychiatric disorders in medical inpatients. J Nerv Ment Dis. 1996; 184 (1):43-51.

E. Prescott et al , Socioeconomic status, lung function and admission to hospital for COPD: results from the Copenhagen City Heart Study , Eur Respir J 1999; 13: 1109±1114, and the Copenhagen City Heart Study Group

White RJ et al , Anxiety and depression in severe chronic obstructive pulmonary disease: the effects ofpulmonary rehabilitation. J Cardiopulm Rehabil. 1999 Nov-Dec;19(6):362-5.

Mikkelson et al , Anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). A review . Nord J Psychiatry 2004;58:65_/70.Oslo. ISSN 0803-9488.

Zhenying CAO et al , Frequent hospital readmissions for acute exacerbation of COPD and their associated factors, Respirology,Volume 11, Issue 2, pages 188–195, March 2006

Minna J Hynninen , Factors affecting health status in COPD patients with co-morbid anxiety or depression International Journal of COPD 2007:2(3) 323–328

MeiLan K. Gender and Chronic Obstructive Pulmonary Disease Am J Respir Crit Care Med Vol 176. pp 1179–1184, 2007

Janet Maurer et al(2008) Anxiety and Depression in COPD , Current Understanding, Unanswered Questions and Research Needs (CHEST / 134 / 4 / OCTOBER, 2008 SUPPLEMENT)

Wanning Xu , Independent Effect of Depression and Anxiety on Chronic Obstructive Pulmonary Disease Exacerbations and Hospitalizations , Am J Respir Crit Care Med Vol 178. pp 913–920, 2008


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