Prevalence of depression and its associated factors in bronchiectasis: findings from KMBARC registry
Ji-Ho Lee, Won‐Yeon Lee, Suk Joong Yong, Woo Jin Kim, Sooim Sin, Chang Youl Lee, Youlim Kim, Ji Ye Jung, Sang‐Ha Kim, the KMBARC, Yeon‐Mok Oh, Hyun Lee, Hayoung Choi, Yun Su Sim, Kwang Ha Yoo, Seung Jun Lee, Tae‐Hyung Kim, Bumhee Yang, Ina Jeong, Soo‐Jung Um, Deog Kyeom Kim, Ji-Hyun Lee, Byoung Soo Kwon, Young‐Jae Cho, Chang‐Hoon Lee, Chin Kook Rhee, Sang Haak Lee, Ju-Ok Na, An‐Soo Jang, Changhwan Kim, Hyun Kuk Kim, Hye Yun Park, Jae Seung Lee, Sei Won Lee, Seung Won, Sung‐Yoon Kang, Yee Hyung Kim, Yong Bum Park, Soyoung Park, Jung-Hyun Kim, Young-Soon Yoon, Yun Jeong Jeong, Jung-Kyu Lee, Ki Uk Kim, Hyun-Kyung Lee, Eun Kyung Kim, Se Hee Lee, Jae Sung Choi, Hyung Koo Kang, Yong Soo Kwon, Jae Ha Lee
Abstract
BACKGROUND: With the emergence of bronchiectasis as a common respiratory disease, epidemiological data have accumulated. However, the prevalence and impact of psychological comorbidities were not sufficiently evaluated. The present study examined the prevalence of depression and its associated factors in patients with bronchiectasis. METHODS: This study involved a multicenter cohort of bronchiectasis patients recruited from 33 pulmonary specialist hospitals. The baseline characteristics and bronchiectasis-related factors at enrollment were analyzed. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). RESULTS: Of the 810 patients enrolled in the study, 168 (20.7%) patients had relevant depression (PHQ-9 score ≥ 10), and only 20 (11.9%) patients had a diagnosis of depression. Significant differences were noted in the depressive symptoms with disease severity, which was assessed using the Bronchiectasis Severity Index and E-FACED (all p < 0.001). Depressive symptoms inversely correlated with quality-of-life (r = - 0.704, p < 0.001) and positively correlated with fatigue severity score (r = 0.712, p < 0.001). Multivariate analysis showed that depression was significantly associated with the modified Medical Research Council dyspnea scale ≥ 2 (OR 2.960, 95% CI 1.907-4.588, p = < 0.001) and high number of exacerbations (≥ 3) in the previous year (OR 1.596, 95% CI 1.012-2.482, p = 0.041). CONCLUSIONS: Depression is common, but its association with bronchiectasis was underrecognized. It negatively affected quality-of-life and presented with fatigue symptoms. Among the bronchiectasis-related factors, dyspnea and exacerbation were closely associated with depression. Therefore, active screening for depression is necessary to optimize the treatment of bronchiectasis. TRIAL REGISTRATION: The study was registered at Clinical Research Information Service (CRiS), Republic of Korea (KCT0003088). The date of registration was June 19th, 2018.