Prevalence of depressive symptoms in Japanese male patients with chronic obstructive pulmonary disease


Hideaki Senjyu, PhD, Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan. Email:


Aim:  The objective of this study was to utilize commonly applied tools, the Hospital Anxiety and Depression Scale – Depression subscale (HADS-D) and the Center for Epidemiological Studies Depression Scale (CES-D), to screen for depressive symptoms in patients with stable chronic obstructive pulmonary disease (COPD). Furthermore, we sought to identify whether differences existed in the prevalence of depressive symptoms as assessed by CES-D and HADS-D, and predictors of depressive symptoms.

Methods:  The presence of depressive symptoms in 80 outpatients and 51 inpatients with stable COPD was assessed using the CES-D and HADS-D. Data regarding sex, educational level, body mass index, smoking index and pulmonary function were obtained to evaluate their independent contribution as predictors of depressive symptoms.

Results:  The prevalence of depressive symptoms was 29.8% based on CES-D and 40.5% based on HADS-D. A MacNemar test of COPD severity and analysis of the results of depressive symptoms based on CES-D and HADS-D revealed significant differences. Logistic regression analysis suggested that ‘severity’ is a predictor of depressive symptoms as assessed by CES-D, whereas ‘body mass index’, ‘education level’ and ‘setting’ were predictors of depressive symptoms as assessed by HADS-D.

Conclusions:  The prevalence of depressive symptoms differed when assessed with CES-D and HADS-D. The reasons behind this difference include the fact that HADS-D frequently detected depressive symptoms in patients with mild COPD as well as a tendency for HADS-D to be strongly influenced by education levels. In contrast, the severity of COPD was reflected in CES-D. It is possible that prevalence of depressive symptoms differs in accordance with the applied screening tool.