Anxiety and depression in patients with chronic obstructive pulmonary disease and their relation to serum vitamin D levels

Objectives: To determine whether serum vitamin D levels wererelated to the prevalence of anxiety and depression among patientswith chronic obstructive pulmonary disease (COPD), as well as theirspirometry parameters, disease severity, and other clinical findings.Materials and Methods: Ninety-two stable patients withCOPD aged over 18 years with no exacerbations in the previousmonth were included. Symptom severity was assessed using themodified Medical Research Council (mMRC) dyspnea scale andCOPD Assessment Test (CAT) scores. Spirometry tests wereperformed and previous hospitalization histories were recordedto determine ABCD groups of the patients according to theircombined COPD assessments. Their Body mass index, airflowObstruction, Dyspnea and Exercise capacity (BODE) indices werecalculated and the Hospital Anxiety and Depression Scale (HADS)was administered. Serum vitamin D levels were determined usingimmune electrochemiluminescence.Results: According to the HADS scores, 16 patients (17.4%) hadthe risk of anxiety and 29 (31.5%) had the risk of depression. Therisk of anxiety differed significantly (P= 0.016 Fischer’s exact test)between the ABCD groups. Anxiety scores were positively correlatedwith both mMRC (r= 0.315; P= 0.002) and CAT (r= 0.445; P= 0.000)scores. Similarly, depression scores correlated positively with mMRC(r= 0.249; P= 0.017) and CAT (r= 0.373; P= 0.000) scores. Neitheranxiety nor depression scores were significantly correlated with % ofpredicted FEV1 (p= 0.339, P= 0.671). Serum vitamin D levels wereinversely correlated with anxiety (r= -0.215; P= 0.039) and depression(r= -0.244; P= 0.019) scores. Anxiety scores were positively correlatedwith BODE although not statistically significantly (r= 0.199; P= 0.058).Conclusion: A negative correlation was revealed betweenserum vitamin D levels and HADS scores, and symptom scoreswere positively correlated to HADS scores, independent of % ofpredicted FEV1.

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  • Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease / 2018 Report. Accessed: 5 October, 2017 Available at: http://www. goldcopd.org.
  • Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006; 3: e442. doi: 10.1371/journal.pmed.0030442
  • Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006; 27: 397-412. doi: 10.1183/09031936.06.00025805
  • Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009; 33: 1165-85. doi: 10.1183/09031936.00128008
  • Maurer J, Rebbapragada V, Borson S, et al. Anxiety and depression in COPD: current understanding, unanswered questions, and research needs. Chest 2008; 134(4 Suppl): 43S-56S. doi: 10.1378/chest.08-0342
  • Hynninen KM, Breitve MH, Wiborg AB, Pallesen S, Nordhus IH. Psychological characteristics of patients with chronic obstructive pulmonary disease: a review. J Psychosom Res 2005; 59: 429-43. doi: 10.1016/j.jpsychores.2005.04.007
  • 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: 1767-74. doi: 10.1016/j. rmed.2006.01.026
  • Cleland JA, Lee AJ, Hall S. Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. Fam Pract 2007; 24: 217-23. doi: 10.1093/fampra/cmm009
  • Pascal OI, Trofor AC, Lotrean LM, Filipeanu D, Trofor L. Depression, anxiety and panic disorders in chronic obstructive pulmonary disease patients: correlations with tobacco use, disease severity and quality of life. Tob Induc Dis 2017; 15: 23. doi: 10.1186/s12971-017-0128-9
  • Kjaergaard M, Waterloo K, Wang CE, et al. Effect of vitamin D supplement on depression scores in people with low levels of serum 25-hydroxyvitamin D: nested case-control study and randomised clinical trial. Br J Psychiatry 2012; 201: 360- 8. doi: 10.1192/bjp.bp.111.104349
  • Sanders KM, Stuart AL, Williamson EJ, et al. Annual high-dose vitamin D3 and mental well-being: randomised controlled trial. Br J Psychiatry 2011; 198: 357-64. doi: 10.1192/bjp.bp.110.087544
  • Milaneschi Y, Hoogendijk W, Lips P, et al. The association between low vitamin D and depressive disorders. Mol Psychiatry 2014;19:444-51. doi: 10.1038/mp.2013.36
  • Zhao G, Ford ES, Li C, Balluz LS. No associations between serum concentrations of 25-hydroxyvitamin D and parathyroid hormone and depression among US adults. Br J Nutr 2010; 104: 1696-702. doi: 10.1017/S0007114510002588
  • Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J 2005; 26: 319-38. doi: 10.1183/09031936.05.00034805
  • Bestall JC, Paul EA, Garrod R, et al. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999; 54: 581-6.
  • Yorgancioğlu A, Polatli M, Aydemir Ö, et al. KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği. Tuberk Toraks 2012; 60: 314-320.
  • Aydemir Ö, Güvenir T, Küey L, Kültür S. Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi 1997; 8: 280-7.
  • Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350: 1005-12. doi: 10.1056/NEJMoa021322
  • ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111-7. doi: 10.1164/ ajrccm.166.1.at1102
  • Henry HL, Bouillon R, Norman AW, et al. 14th Vitamin D Workshop consensus on vitamin D nutritional guidelines. J Steroid Biochem Mol Biol 2010; 121: 4-6. doi: 10.1016/j. jsbmb.2010.05.008
  • Raiten DJ, Picciano MF. Vitamin D and health in the 21st century: bone and beyond. Executive summary. Am J Clin Nutr 2004; 80(6 Suppl): 1673S-7S. doi:
  • Atli T, Gullu S, Uysal AR, Erdogan G. The prevalence of Vitamin D deficiency and effects of ultraviolet light on Vitamin D levels in elderly Turkish population. Arch Gerontol Geriatr 2005; 40: 53-60. doi: 10.1016/j.archger.2004.05.006
  • Hekimsoy Z, Dinc G, Kafesciler S, et al. Vitamin D status among adults in the Aegean region of Turkey. BMC Public Health 2010; 10: 782. doi: 10.1186/1471-2458-10-782
  • Forli L, Bjortuft O, Boe J. Vitamin D status in relation to nutritional depletion and muscle function in patients with advanced pulmonary disease. Exp Lung Res 2009; 35: 524-38.
  • Franco CB, Paz-Filho G, Gomes PE, et al. Chronic obstructive pulmonary disease is associated with osteoporosis and low levels of vitamin D. Osteoporos Int 2009; 20: 1881-7. doi: 10.1007/s00198-009-0890-5
  • Holmgaard DB, Mygind LH, Titlestad IL, et al. Serum vitamin D in patients with chronic obstructive lung disease does not correlate with mortality—results from a 10-year prospective cohort study. PLoS One 2013; 8: e53670. doi: 10.1371/journal.pone.0053670
  • Persson LJ, Aanerud M, Hiemstra PS, et al. Chronic obstructive pulmonary disease is associated with low levels of vitamin D. PLoS One 2012; 7: e38934. doi: 10.1371/ journal.pone.0038934
  • Hill K, Geist R, Goldstein RS, Lacasse Y. Anxiety and depression in end-stage COPD. Eur Respir J 2008; 31: 667- 77. doi: 10.1183/09031936.00125707
  • Hanania NA, Mullerova H, Locantore NW, et al. Determinants of depression in the ECLIPSE chronic obstructive pulmonary disease cohort. Am J Respir Crit Care Med 2011; 183: 604- 11. doi: 10.1164/rccm.201003-0472OC
  • Horita N, Kaneko T, Shinkai M, et al. Depression in Japanese patients with chronic obstructive pulmonary disease: a cross-sectional study. Respir Care 2013; 58: 1196-203. doi: 10.4187/respcare.02065
  • Iguchi A, Senjyu H, Hayashi Y, et al. Relationship between depression in patients with COPD and the percent of predicted FEV(1), BODE index, and health-related quality of life. Respir Care 2013; 58: 334-9. doi: 10.4187/respcare.01844
  • Funk GC, Kirchheiner K, Burghuber OC, Hartl S. BODE index versus GOLD classification for explaining anxious and depressive symptoms in patients with COPD – a crosssectional study. Respir Res 2009; 10: 1. doi: 10.1186/1465- 9921-10-1
  • Gonzalez-Gutierrez MV, Guerrero Velazquez J, Morales Garcia C, et al. Predictive Model for Anxiety and Depression in Spanish Patients with Stable Chronic Obstructive Pulmonary Disease. Arch Bronconeumol 2016; 52: 151-7. doi: 10.1016/j.arbres.2015.09.003
Marmara Medical Journal-Cover
  • ISSN: 1019-1941
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1988
  • Yayıncı: Marmara Üniversitesi