An Analysis of Self-Reported Depressed Mood in Chronic Obstructive Pulmonary Disease.

A secondary analysis of data from the Nocturnal Oxygen Therapy Trial (NOTT) and the Intermittent Positive Pressure Breathing (IPPB) Study was conducted to test a recursive path model for explaining depressed mood in chronic obstructive pulmonary disease. Various disease-related factors (arterial oxygen saturation, exercise tolerance, and neuropsychological impairment) as well as selected sociodemographic and psychological factors (marriage, smoking pack-years, age, education, occupational status, and patients' self-reported physical and social role functioning) were included in the model. The depression-dejection scale from the Profile of Mood States (POMS) was the measure of self-reported depressed mood, the Russell Neuringer Average Impairment Rating (RN-AIR) was the measure of neuropsychological impairment, and the total dysfunction score from the Sickness Impact Profile (SIP) was the measure of patients' perceived illness dysfunction. Data were available for 203 NOTT patients and 100 IPPB patients. The analysis of the combined NOTT/IPPB data showed most of the hypothesized linkages in the proposed model to be statistically significant. Self-reported depressed mood was strongly predicted by patients' perceptions of their functioning abilities. Neuropsychological impairment had a weak direct linkage to depressed mood, but it also indirectly impacted on mood by negatively influencing patients' physical and psychosocial role functioning. Marriage had a small positive effect on patients' exercise tolerance levels but a minimal overall impact on depressed mood. Better educated, versus less well educated patients perceived themselves to be less incapacitated by COPD in early stages of the disease, but education had less influence on patients' self-reported functioning in late-stage COPD. The findings support clinicians' assertions that interventions which focus on assisting COPD patients to maintain their physical and psychosocial functioning may help to prevent or alleviate depressed mood. Since neuropsychological impairment, as well as lowered exercise tolerance, significantly contributes to COPD patients' physical and psychosocial role dysfunction, patients' neuropsychological abilities should be taken into account when planning interventions. Suggestions for interventions to improve COPD patients' life quality are briefly discussed.PhDPublic healthUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/159978/1/8412189.pd