Official publication of Rawalpindi Medical University
The Prevalence & Severity of Depression in patients with chronic obstructive airway disease

Supplementary Files



Chronic obstructive pulmonary disease (COPD), Hamilton depression grades (HAM-D), Forced Expiratory Volume in one second (FEV1).

How to Cite

Awan S, Ambreen A, Zaheer N, Sabir A, Daud S, Athar R. The Prevalence & Severity of Depression in patients with chronic obstructive airway disease. JRMC [Internet]. 2023 Apr. 1 [cited 2024 Jul. 17];27(1). Available from:


Objective:  To determine the Prevalence & Severity of depression in Chronic Obstructive Airway Diseases (COPD) patients.

Background: Chronic Obstructive Airway Disease is a chronic heterogeneous disease that is also progressive. Depression is a common entity in chronic diseases. COPD causes long-term respiratory symptoms and depression is commonly found in these patients. The symptoms of these two diseases are overlapping and depression in COPD patients’ needs to be diagnosed and adequately treated. Untreated patients lead to poor control of respiratory symptoms and further deterioration of the illness. Our study aimed to determine prevalence and severity of depression in COPD patients using HAM-D score.

Material and Methods: This study was conducted in Medicine & Pulmonology OPD, Fuji Foundation Hospital, Rawalpindi from August 2019 to February 2021. Using a cross sectional study design, a total of 169 cases of COPD were recruited and tested for the presence of absence of depression using the HAM-D rating scale and observations were recorded.

Results: Total 169 patients recruited in this study with female & male percentage of 59% and 47% respectively.  The Mean duration of illness was 11.5 years ± 6.48. The incidence of Anxiety & Depression was high (45% and 36%) in moderate to severe disease with total prevalence of 54 % among participants in the study.

Conclusion: Anxiety & depression is commonly prevalent in COPD patients. Female patients are found to have more psychological disturbance irrespective to their COPD severity. Psychological impairment must be carefully evaluated in patients having COPD.


Riley CM, Sciurba FC. Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review. JAMA 2019; 321(8): 786–797. [PubMed]

Global Initiative for Chronic Obstructive Lung Disease – GOLD

WHO Global Health Estimates

Mirza S, Clay RD, Koslow MA, et al.. COPD guidelines: a review of the 2018 GOLD report. Mayo Clin Proc 2018; 93: 1488–1502. [PubMed] [Google Scholar]

Funk G, Kirchheiner K, Burghube O and Hartl S. BODE index versus GOLD classification for explaining anxious and depressive symptoms in patients with COPD, a cross-sectional study. Respir Res. 2015;10(1):1

Blakemore A, Dickens C, Chew-Graham CA, et al.. Depression predicts emergency care use in people with chronic obstructive pulmonary disease: a large cohort study in primary care. Int J Chron Obstruct Pulmon Dis 2019; 14: 1343–1353. [PMC free article] [PubMed] [Google Scholar]

Hitti M. Screening and treating depression in chronic obstructive pulmonary disease patients may help, WebMD. Health News. 2008 Oct 24.

Hill K, Geist R, Goldstein RS, Lacasse Y, Anxiety and depression in end-stage COPD, Eur Respir .J 2018;31:667-77

lakemore A, Dickens C, Chew-Graham CA, et al.. Depression predicts emergency care use in people with chronic obstructive pulmonary disease: a large cohort study in primary care. Int J Chron Obstruct Pulmon Dis 2019; 14: 1343–1353. [PMC free article] [PubMed] [Google Scholar]

Julian LJ, Gregorich SE, Earnest G, Eisner MD,Chen H. Screening for depression in chronic obstructive pulmonary disease. COPD. 2017 Dec; 6(6):452–8.

Felker B, Bush KR, Hare O, Shofer JB, Shores MM, Au DH. Added burden of mental disorders on health status among patients with chronic obstructive pulmonary disease. Prime Care Companion J Clin Psychiat. 2010;12(4):858

Marco FD, Verga M, Reggente M, Casanova FM, Santus P, Blasi F et al. Anxiety and depression in COPD patients: The roles of gender and disease severity. Respirat Med. 2006 11;(10):1767-74

Ahmed B, Enam SF, Iqbal Z, et al.. Depression and anxiety: a snapshot of the situation in Pakistan. Int J Neurosci Behav Sci 2016; 4(2): 32–36. [Google Scholar]

Goodwin RD, Lavoie KL, Lemeshow AR, Jenkins E, Brown ES, Fedoronko DA. Depression, anxiety, and COPD: The unexamined role of nicotine dependence. Nicotine Tob Res. 2012 ;14 (2):176-83.

Zimmerman M, Martinez JH, Young D, Chelminski I, Dalrymple K. Severity classification on the Hamilton Depression Rating Scale. J Affect Disord 2013;150:384–388

Himani G, Badini A, Nanji K. Depression and its associated factors among patients with chronic obstructive pulmonary disease in Karachi, Pakistan. Cureus 2018; 10(7): e2930. [PMC free article] [PubMed] [Google Scholar

Deng D, Zhou A, Chen P and Shuang Q, A New Multidimensional Index to Better Predict Frequent COPD Exacerbators with Inclusion of Depression Score; Int J Chron Obstruct Pulmon Dis. 2020; 15: 249–259

Wanning Xu, Paul CJ , Shapiro S, Lin Y, Yang T, Platt R et al. Independent Effect of Depression and Anxiety on Chronic Obstructive Pulmonary Disease Exacerbations and Hospitalizations; Amer J of Resp Med 2008;37(2) 52-8

Tsai T, Livneh H, Lu MC, Tsai P , Chen PC, Chang F. Depression among patients with COPD: a population-based cohort study ; BMC Public Health 2013;13:976-84

Yohannes M, Alexopoulos S. Depression and anxiety in patients with COPD. PMC 2015;23(3)234-8

Nicolini A, Barbagelata E, Tagliabue E, et al.. Gender differences in chronic obstructive pulmonary diseases: a narrative review. Panminerva Med 2018; 60(4): 192–199. [PubMed] [Google Scholar]

Siddharthan T, Grigsby MR, Goodman D, et al.. Association between household air pollution exposure and chronic obstructive pulmonary disease outcomes in 13 low- and middle-income country settings. Am J Respir Crit Care Med 2018; 197(5): 611–620. [PMC free article] [PubMed] [Google Scholar]

Singh A, Misra N; Loneliness, depression and sociability in old age; Ind Psychiatry J. 2009; 18(1):51-5

Park Y , Jung JY , Kim YS , Chung KS , Song JH, Kim SY, Kim EY, Kang YA, Park MS , Chang J , Leem AY; Relationship between depression and lung function in the general population in Korea: a retrospective cross-sectional study; International Journal of Chronic Obstructive Pulmonary Disease; 18 July 2018 Volume 2018:13 Pages 2207—2213

Manen V, Bindels P, Dekker FW, Ijzermans CJ, Zee JS, Schade E. Risk of depression in patients with chronic obstructive pulmonary disease and its determinants. Eurp J of Thorax 2002;12(30:412-9

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2023 Shomaila Awan, Asma Ambreen, Nabila Zaheer, Asma Sabir, Sara Daud, Rizwan Athar