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Clinical Usefulness of the Two-Question Assessment Tool for Depressive Symptoms in Japanese Patients with Chronic Obstructive Pulmonary Disease

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Abstract

Purpose

Depressive symptoms are highly prevalent in patients with chronic obstructive pulmonary disease (COPD) and have been associated with poor outcomes. Developing a concise questionnaire to measure depressive symptoms in COPD patients is needed in outpatient settings. We evaluated the clinical usefulness of a concise two-question instrument to assess depressive symptoms in patients with COPD.

Methods

The study was conducted as a cross-sectional analysis in patients with COPD. All patients completed a self-reported questionnaire consisting of the two-question instrument, as well as a shortened version of the Center for Epidemiologic Studies Depression Scale (CESD-10) to measure depressive symptoms. Performance of the two-question instrument was evaluated using the results for CESD-10 as standard. We also measured patients’ health-related quality of life using the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8) to determine whether the instrument was related to SF-8.

Results

Sensitivity of the two-question instrument in the detection of depressive symptoms was 73.3 % (95 % confidence interval [CI] 51–95.7), specificity was 73 % (95 % CI 58.7–87.3), and area under the receiver operating characteristics curve was 0.73 (95 % CI 0.59–0.87). When study patients were divided into two groups with a cutoff of 1 point on the two-question instrument, scores for all subscales of the SF-8 except “bodily pain” were significantly lower in patients with than without depressive symptoms.

Conclusions

This concise two-question instrument is useful as assessment of depressive symptom in patients with COPD in busy outpatient settings.

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Acknowledgments

We thank Dr. Toshihiko Ihi of National Hospital Organization Miyazaki Higashi Hospital, Dr. Kiyoshi Matsumoto of Shimin-no-mori Hospital, Dr. Takeaki Hiratsuka of Miyazaki Prefectural Nichinan Hospital, and Dr. Tomohiro Shirahama of Senwakai Chiyoda Hospital for data collection. This work was supported by the Ministry of Health, Labor and Welfare, Japan.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Yasuji Arimura, Shigehisa Yanagi, Nobuhiro Matsumoto & Masamitsu Nakazato

  2. Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan

    Shin Yamazaki & Shunichi Fukuhara

  3. Department of Preventive Medicine and Epidemiologic informatics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Misa Takegami

  4. Department of Endocrinology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan

    Yasuaki Hayashino

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  1. Yasuji Arimura
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  2. Shin Yamazaki
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Correspondence to Yasuji Arimura.

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Arimura, Y., Yamazaki, S., Yanagi, S. et al. Clinical Usefulness of the Two-Question Assessment Tool for Depressive Symptoms in Japanese Patients with Chronic Obstructive Pulmonary Disease. Lung 191, 101–107 (2013). https://doi.org/10.1007/s00408-012-9437-1

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  • DOI: https://doi.org/10.1007/s00408-012-9437-1

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