Effect of COPD severity and comorbidities on the result of the PHQ-9 tool for the diagnosis of depression: results from the COSYCONET cohort study.


:The diagnosis of depression, a frequent comorbidity of chronic obstructive pulmonary disease (COPD), is often supported by questionnaires, such as the Patient Health Questionnaire 9 (PHQ-9). It is unknown to which extent its single questions are affected by the clinical characteristics of COPD patients.We addressed this question in 2255 GOLD grade 1-4 patients from the COSYCONET (COPD and Systemic Consequences - Comorbidities Network) COPD cohort. The dependence on COPD severity was assessed using symptoms, exacerbation risk (GOLD A-D; modified Medical Research Council dyspnoea scale (mMRC)), and frequent comorbidities as predictors of PHQ-9 results, while including age, gender, body mass index (BMI) and smoking habits as covariates.Symptoms and exacerbation risk were associated with depression in an additive manner, with mean elevations in the PHQ-9 sum score by 2.75 and 1.44 points, respectively. Asthma, sleep apnoea, gastrointestinal disorders, osteoporosis and arthritis were linked to increases by 0.8 to 1.3 points. Overall, the COPD characteristics contributed to the mean PHQ-9 score by increases from 4.5 or 5.2 to 6.3 points, respectively, when either taking GOLD A as reference or the absence of comorbidities. This finding was independent of the diagnosis of mental disorder or the intake of antidepressants. The presence of COPD led to an increase in the proportion of scores indicating depression from 12 to 22%. Single item analysis revealed homogenous effects regarding GOLD groups, but heterogeneous effects regarding GOLD grades.These findings indicate specific effects of COPD severity on the PHQ-9 depression score, especially symptoms and exacerbation risk, explaining the high prevalence of depression in COPD. Alternative explanations like an overlap of COPD severity and PHQ-9 items are discussed. Of note, we also found COPD treatment effects on depression scores.


Respir Res


Respiratory research


von Siemens SM,Jörres RA,Behr J,Alter P,Lutter J,Lucke T,Söhler S,Welte T,Watz H,Vogelmeier CF,Trudzinski F,Rief W,Herbig B,Kahnert K,COSYCONET study group.




Has Abstract


2019-02-11 00:00:00














  • Cigarette smoke alters the ability of human dendritic cells to promote anti-Streptococcus pneumoniae Th17 response.

    abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) is associated with chronic inflammation and impaired immune response to pathogens leading to bacteria-induced exacerbation of the disease. A defect in Th17 cytokines in response to Streptococcus pneumoniae, a bacteria associated with COPD exacerbations, has been r...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Le Rouzic O,Koné B,Kluza J,Marchetti P,Hennegrave F,Olivier C,Kervoaze G,Vilain E,Mordacq C,Just N,Perez T,Bautin N,Pichavant M,Gosset P

    更新日期:2016-07-26 00:00:00

  • Serum heat shock protein 47 levels in patients with drug-induced lung disease.

    abstract:BACKGROUND:Heat shock protein (HSP) 47 is a collagen-specific molecular chaperone that is required for molecular maturation of various types of collagens. We recently reported that HSP47 serum levels were markedly higher in patients with acute exacerbations of idiopathic pulmonary fibrosis (IPF) when compared with pati...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Kakugawa T,Yokota S,Ishimatsu Y,Hayashi T,Nakashima S,Hara S,Sakamoto N,Matsuoka Y,Kubota H,Mine M,Mukae H,Nagata K,Kohno S

    更新日期:2013-11-20 00:00:00

  • Blockade of advanced glycation end product formation attenuates bleomycin-induced pulmonary fibrosis in rats.

    abstract:BACKGROUND:Advanced glycation end products (AGEs) have been proposed to be involved in pulmonary fibrosis, but its role in this process has not been fully understood. To investigate the role of AGE formation in pulmonary fibrosis, we used a bleomycin (BLM)-stimulated rat model treated with aminoguanidine (AG), a crossl...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Chen L,Wang T,Wang X,Sun BB,Li JQ,Liu DS,Zhang SF,Liu L,Xu D,Chen YJ,Wen FQ

    更新日期:2009-06-24 00:00:00

  • Bidirectional role of IL-6 signal in pathogenesis of lung fibrosis.

    abstract:BACKGROUND:Various signals are known to participate in the pathogenesis of lung fibrosis. Our aim was to determine which signal is predominantly mobilized in the early inflammatory phase and thereafter modulates the development of lung fibrosis. METHODS:Mice received a single dose of 3 mg/kg body weight of bleomycin (...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Kobayashi T,Tanaka K,Fujita T,Umezawa H,Amano H,Yoshioka K,Naito Y,Hatano M,Kimura S,Tatsumi K,Kasuya Y

    更新日期:2015-08-20 00:00:00

  • The importance of balanced pro-inflammatory and anti-inflammatory mechanisms in diffuse lung disease.

    abstract::The lung responds to a variety of insults in a remarkably consistent fashion but with inconsistent outcomes that vary from complete resolution and return to normal to the destruction of normal architecture and progressive fibrosis. Increasing evidence indicates that diffuse lung disease results from an imbalance betwe...

    journal_title:Respiratory research

    pub_type: 杂志文章,评审


    authors: Keane MP,Strieter RM

    更新日期:2002-01-01 00:00:00

  • A retinoid X receptor partial agonist attenuates pulmonary emphysema and airway inflammation.

    abstract:BACKGROUND:Retinoid X receptors (RXRs) are members of the nuclear receptor (NR) superfamily that mediate signalling by 9-cis retinoic acid, a vitamin A derivative. RXRs play key roles not only as homodimers but also as heterodimeric partners, e.g., for retinoic acid receptors, vitamin D receptors, and peroxisome prolif...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Morichika D,Miyahara N,Fujii U,Taniguchi A,Oda N,Senoo S,Kataoka M,Tanimoto M,Kakuta H,Kiura K,Maeda Y,Kanehiro A

    更新日期:2019-01-03 00:00:00

  • Responses of FEV6, FVC, and FET to inhaled bronchodilator in the adult general population.

    abstract:BACKGROUND:The assessment of bronchodilator-induced change in forced vital capacity (FVC) is dependent on forced expiratory time (FET) in subjects with airflow limitation. Limited information is available on the concurrent responses of FVC, forced expiratory volume in six seconds (FEV6), and FET in the bronchodilation ...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Kainu A,Lindqvist A,Sarna S,Lundbäck B,Sovijärvi A

    更新日期:2009-07-28 00:00:00

  • Identification of vitamin D sensitive pathways during lung development.

    abstract:BACKGROUND:We have previously shown that vitamin D deficiency has a detrimental impact on lung development. In this study, we aimed to identify the mechanisms linking vitamin D with lung development using a mouse model of dietary manipulation. METHODS:Female offspring were euthanized at different time-points; embryoni...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Chen L,Wilson R,Bennett E,Zosky GR

    更新日期:2016-04-27 00:00:00

  • Neuropeptides in asthma, chronic obstructive pulmonary disease and cystic fibrosis.

    abstract::The nervous system mediates key airway protective behaviors, including cough, mucus secretion, and airway smooth muscle contraction. Thus, its involvement and potential involvement in several airway diseases has become increasingly recognized. In the current review, we focus on the contribution of select neuropeptides...

    journal_title:Respiratory research

    pub_type: 杂志文章,评审


    authors: Atanasova KR,Reznikov LR

    更新日期:2018-08-06 00:00:00

  • COVID-19 multidisciplinary high dependency unit: the Milan model.

    abstract::COVID-19 is a complex and heterogeneous disease. The pathogenesis and the complications of the disease are not fully elucidated, and increasing evidence shows that SARS-CoV-2 causes a systemic inflammatory disease rather than a pulmonary disease. The management of hospitalized patients in COVID-19 dedicated units is a...

    journal_title:Respiratory research

    pub_type: 杂志文章,评审


    authors: Aliberti S,Amati F,Pappalettera M,Di Pasquale M,D'Adda A,Mantero M,Gramegna A,Simonetta E,Oneta AM,Privitera E,Gori A,Bozzi G,Peyvandi F,Minoia F,Filocamo G,Abbruzzese C,Vicenzi M,Tagliabue P,Alongi S,Blasi F

    更新日期:2020-10-09 00:00:00

  • Anxiety is associated with diminished exercise performance and quality of life in severe emphysema: a cross-sectional study.

    abstract:BACKGROUND:Anxiety in patients with chronic obstructive pulmonary disease (COPD) is associated with self-reported disability. The purpose of this study is to determine whether there is an association between anxiety and functional measures, quality of life and dyspnea. METHODS:Data from 1828 patients with moderate to ...

    journal_title:Respiratory research

    pub_type: 杂志文章,随机对照试验


    authors: Giardino ND,Curtis JL,Andrei AC,Fan VS,Benditt JO,Lyubkin M,Naunheim K,Criner G,Make B,Wise RA,Murray SK,Fishman AP,Sciurba FC,Liberzon I,Martinez FJ,NETT Research Group.

    更新日期:2010-03-09 00:00:00

  • Interstitial lung disease associated with systemic sclerosis (SSc-ILD).

    abstract:BACKGROUND:Systemic sclerosis (SSc) is a rare connective tissue disease with a heterogeneous clinical course. Interstitial lung disease (ILD) is a common manifestation of SSc and a leading cause of death. MAIN BODY:All patients newly diagnosed with SSc should receive a comprehensive clinical evaluation, including asse...

    journal_title:Respiratory research

    pub_type: 杂志文章,评审


    authors: Cottin V,Brown KK

    更新日期:2019-01-18 00:00:00

  • SN50 attenuates alveolar hypercoagulation and fibrinolysis inhibition in acute respiratory distress syndrome mice through inhibiting NF-κB p65 translocation.

    abstract:BACKGROUND:It has been confirmed that NF-κB p65 signaling pathway is involved in the regulation of alveolar hypercoagulation and fibrinolysis inhibition in acute respiratory distress syndrome (ARDS). Whether SN50, a NF-κB cell permeable inhibitor, could attenuate alveolar hypercoagulation and fibrinolysis inhibition in...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Wu Y,Wang Y,Liu B,Cheng Y,Qian H,Yang H,Li X,Yang G,Zheng X,Shen F

    更新日期:2020-05-27 00:00:00

  • Laminin-332 alters connexin profile, dye coupling and intercellular Ca2+ waves in ciliated tracheal epithelial cells.

    abstract:BACKGROUND:Tracheal epithelial cells are anchored to a dynamic basement membrane that contains a variety of extracellular matrix proteins including collagens and laminins. During development, wound repair and disease of the airway epithelium, significant changes in extracellular matrix proteins may directly affect cell...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Isakson BE,Olsen CE,Boitano S

    更新日期:2006-08-02 00:00:00

  • Primary data, claims data, and linked data in observational research: the case of COPD in Germany.

    abstract:BACKGROUND:Real-world evidence (RWE) can inform patient management decisions, but RWE studies are associated with limitations. Linkage of different RWE data types could address such limitations by enriching data and improving scientific quality. Using the example of chronic obstructive pulmonary disease (COPD) in Germa...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Mueller S,Gottschalk F,Groth A,Meeraus W,Driessen M,Kohlmann T,Wilke T

    更新日期:2018-08-30 00:00:00

  • Prevention of bronchial hyperreactivity in a rat model of precapillary pulmonary hypertension.

    abstract:BACKGROUND:The development of bronchial hyperreactivity (BHR) subsequent to precapillary pulmonary hypertension (PHT) was prevented by acting on the major signalling pathways (endothelin, nitric oxide, vasoactive intestine peptide (VIP) and prostacyclin) involved in the control of the pulmonary vascular and bronchial t...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Habre W,Albu G,Janosi TZ,Fontao F,von Ungern-Sternberg BS,Beghetti M,Petak F

    更新日期:2011-04-27 00:00:00

  • Local therapy with CpG motifs in a murine model of allergic airway inflammation in IFN-beta knock-out mice.

    abstract:BACKGROUND:CpG oligodeoxynucleotides (CpG-ODN) are capable of inducing high amounts of type I IFNs with many immunomodulatory properties. Furthermore, type-I IFNs have been proposed to play a key role in mediating effects of CpG-ODN. The precise role of IFN-beta in the immunomodulatory effects of CpG-ODN is not known. ...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Matheu V,Treschow A,Teige I,Navikas V,Issazadeh-Navikas S

    更新日期:2005-03-05 00:00:00

  • 24-h bronchodilation and inspiratory capacity improvements with glycopyrrolate/formoterol fumarate via co-suspension delivery technology in COPD.

    abstract:BACKGROUND:Symptoms of chronic obstructive pulmonary disease may vary throughout the day and it is important that therapeutic approaches provide 24-h symptom control. We report the results of two phase IIIb crossover studies, PT003011 and PT003012, investigating the 24-h lung function profile of GFF MDI (glycopyrrolate...

    journal_title:Respiratory research

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Reisner C,Gottschlich G,Fakih F,Koser A,Krainson J,Delacruz L,Arora S,Feldman G,Pudi K,Siddiqui S,Orevillo C,Maes A,St Rose E,Martin U

    更新日期:2017-08-18 00:00:00

  • The anti-proliferative and anti-inflammatory response of COPD airway smooth muscle cells to hydrogen sulfide.

    abstract:BACKBROUND:COPD is a common, highly debilitating disease of the airways, primarily caused by smoking. Chronic inflammation and structural remodelling are key pathological features of this disease caused, in part, by the aberrant function of airway smooth muscle (ASM). We have previously demonstrated that hydrogen sulfi...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Perry MM,Tildy B,Papi A,Casolari P,Caramori G,Rempel KL,Halayko AJ,Adcock I,Chung KF

    更新日期:2018-05-09 00:00:00

  • Surfactant protein D attenuates sub-epithelial fibrosis in allergic airways disease through TGF-β.

    abstract:BACKGROUND:Surfactant protein D (SP-D) can regulate both innate and adaptive immunity. Recently, SP-D has been shown to contribute to the pathogenesis of airway allergic inflammation and bleomycin-induced pulmonary fibrosis. However, in allergic airways disease, the role of SP-D in airway remodeling remains unknown. Th...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Ogawa H,Ledford JG,Mukherjee S,Aono Y,Nishioka Y,Lee JJ,Izumi K,Hollingsworth JW

    更新日期:2014-11-29 00:00:00

  • Role and regulation of Abelson tyrosine kinase in Crk-associated substrate/profilin-1 interaction and airway smooth muscle contraction.

    abstract:BACKGROUND:Airway smooth muscle contraction is critical for maintenance of appropriate airway tone, and has been implicated in asthma pathogenesis. Smooth muscle contraction requires an "engine" (myosin activation) and a "transmission system" (actin cytoskeletal remodeling). However, the mechanisms that control actin r...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Wang Y,Rezey AC,Wang R,Tang DD

    更新日期:2018-01-05 00:00:00

  • Fibrocytes are increased in lung and peripheral blood of patients with idiopathic pulmonary fibrosis.

    abstract:BACKGROUND:Fibrocytes are implicated in Idiopathic Pulmonary Fibrosis (IPF) pathogenesis and increased proportions in the circulation are associated with poor prognosis. Upon tissue injury, fibrocytes migrate to the affected organ. In IPF patients, circulating fibrocytes are increased especially during exacerbations, h...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Heukels P,van Hulst JAC,van Nimwegen M,Boorsma CE,Melgert BN,van den Toorn LM,Boomars KAT,Wijsenbeek MS,Hoogsteden H,von der Thüsen JH,Hendriks RW,Kool M,van den Blink B

    更新日期:2018-05-10 00:00:00

  • Sex-specific lung functional changes in adult mice exposed only to second-hand smoke in utero.

    abstract:BACKGROUND:An increasing number of epidemiological and experimental studies have associated exposure to second-hand smoke (SHS) during pregnancy with adverse outcomes in newborns. As we have previously shown in mice, in utero exposure to SHS at critical stages of fetal development, results in altered lung responses and...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Noël A,Xiao R,Perveen Z,Zaman H,Le Donne V,Penn A

    更新日期:2017-06-27 00:00:00

  • Budesonide/formoterol and formoterol provide similar rapid relief in patients with acute asthma showing refractoriness to salbutamol.

    abstract:BACKGROUND:To compare the efficacy and safety of budesonide/formoterol (Symbicort) with formoterol (Oxis) in the treatment of patients with acute asthma who showed evidence of refractoriness to short-acting beta2-agonist therapy. METHODS:In a 3 hour, randomized, double-blind study, a total of 115 patients with acute a...

    journal_title:Respiratory research

    pub_type: 杂志文章,随机对照试验


    authors: Bateman ED,Fairall L,Lombardi DM,English R

    更新日期:2006-01-24 00:00:00

  • Impact of interleukin-6 on hypoxia-induced pulmonary hypertension and lung inflammation in mice.

    abstract:BACKGROUND:Inflammation may contribute to the pathogenesis of various forms of pulmonary hypertension (PH). Recent studies in patients with idiopathic PH or PH associated with underlying diseases suggest a role for interleukin-6 (IL-6). METHODS:To determine whether endogenous IL-6 contributes to mediate hypoxic PH and...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Savale L,Tu L,Rideau D,Izziki M,Maitre B,Adnot S,Eddahibi S

    更新日期:2009-01-27 00:00:00

  • Role of TNF-alpha in lung tight junction alteration in mouse model of acute lung inflammation.

    abstract::In the present study, we used tumor necrosis factor-R1 knock out mice (TNF-alpha R1KO) to understand the roles of TNF-alpha on epithelial function in models of carrageenan-induced acute lung inflammation. In order to elucidate whether the observed anti-inflammatory status is related to the inhibition of TNF-alpha, we ...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Mazzon E,Cuzzocrea S

    更新日期:2007-10-30 00:00:00

  • A 3D epithelial-mesenchymal co-culture model of human bronchial tissue recapitulates multiple features of airway tissue remodeling by TGF-β1 treatment.

    abstract:BACKGROUND:The collagen gel contraction assay measures gel size to assess the contraction of cells embedded in collagen gel matrices. Using the assay with lung fibroblasts is useful in studying the lung tissue remodeling process in wound healing and disease development. However, the involvement of bronchial epithelial ...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Ishikawa S,Ishimori K,Ito S

    更新日期:2017-11-22 00:00:00

  • Pentraxin 3 promotes airway inflammation in experimental asthma.

    abstract:BACKGROUND:Pentraxin 3 (PTX3) regulates multiple aspects of innate immunity and tissue inflammation. Recently, it has been reported that PTX3 deficiency enhances interleukin (IL)-17A-dominant pulmonary inflammation in an ovalbumin (OVA)-induced mouse asthma model. However, whether PTX3 treatment would provide protectio...

    journal_title:Respiratory research

    pub_type: 杂志文章


    authors: Gao P,Tang K,Lu Y,Huang Z,Wang S,Wang M,Wang J,Zhao J,Xie J

    更新日期:2020-09-16 00:00:00

  • Signaling and regulation of G protein-coupled receptors in airway smooth muscle.

    abstract::Signaling through G protein-coupled receptors (GPCRs) mediates numerous airway smooth muscle (ASM) functions including contraction, growth, and "synthetic" functions that orchestrate airway inflammation and promote remodeling of airway architecture. In this review we provide a comprehensive overview of the GPCRs that ...

    journal_title:Respiratory research

    pub_type: 杂志文章,评审


    authors: Billington CK,Penn RB

    更新日期:2003-01-01 00:00:00

  • Understanding alveolarization to induce lung regeneration.

    abstract:BACKGROUND:Gas exchange represents the key physiological function of the lung, and is dependent upon proper formation of the delicate alveolar structure. Malformation or destruction of the alveolar gas-exchange regions are key histopathological hallmarks of diseases such as bronchopulmonary dysplasia (BPD), chronic obs...

    journal_title:Respiratory research

    pub_type: 杂志文章,评审


    authors: Rodríguez-Castillo JA,Pérez DB,Ntokou A,Seeger W,Morty RE,Ahlbrecht K

    更新日期:2018-08-06 00:00:00