Introduction

Limited data exist regarding the association between COPD assessment test (CAT) and Patient Health Questionaire-9 (PHQ-9) scores for depression. This study aimed to determine the association between CAT and depression as measured using the PHQ-9 and explore CAT score as a predictor of depression. We hypothesized an increased CAT score indicates the need to investigate for concomitant depression. The study also determined the association between GOLD Stage classification and depression.

Methods

We conducted a nationwide retrospective cross sectional study in patients from the Philippine COPD Profile and Survival Study (CPASS) with spirometry-confirmed COPD, age of ³ 40 years, completed both CAT and PHQ-9 scores and never been diagnosed with depression or psychiatric disease.

Results

We included 1,950 patients and 529 (27.1%) had a PHQ-9 score of at least 5, classified as with depression. Increased depression was seen with increasing CAT scores. CAT scores of 10-19, 20-29, ³ 40 had an OR for depression at 4.2, 16.8 and 31.6, respectively (p<0.001). GOLD Stage B and D or those with more symptoms have the OR for depression at 6.4 and 8.1, respectively (p<0.001).

Conclusion

In a developing country setting, while CAT scoring denotes the impact of COPD on a patient?s life in terms of symptoms and perceived health status, an increasing score correlate well with patients that should be formally evaluated for depression.