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Post by gerald on Apr 5, 2018 13:58:12 GMT -5
I think it is important to periodically run through the questions here as a self check. It is easy to fall into a depressive state not always easy to recognise it. ------------------------------------------ April 05, 2018 Assessing Depression in COPD With PHQ-9, PHQ-2 Attachment DeletedAttachment DeletedThe Patient Health Questionnaire-9 (PHQ-9) demonstrates validity as an instrument to measure depression in patients with chronic obstructive pulmonary disease (COPD), according to the results of a study published in the Journal of Affective Disorders. Depression in patients with COPD is common, with prevalence estimates ranging from 15% to 40%. It is associated with higher symptom burden and lower quality of life, worse functional capacity, increased exacerbations of COPD, and higher mortality. Thus, there is a need to assess patients with COPD routinely for depression and to identify valid assessment tools. Michael Schuler, of the University of Wurzburg, Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Wurzburg, Germany, and colleagues conducted a secondary analysis of 561 patients with COPD who filled out the PHQ-9 questionnaire at the beginning, end, and 3, 6, 9, and 12 months after pulmonary inpatient rehabilitation. The PHQ-2 was used as a comparator. They used structural equation modeling to examine factorial validity and measurement invariance between gender, Global Initiative on Chronic Obstructive Lung Disease (GOLD) severity group, and over time. They assessed concordance using Cohen's Kapp, Yules Y, and positive and negative agreement. Although concordance between the 2 instruments was substantial, more patients were classified as having clinically relevant depression by PHQ-9 (31.7%) than by PHQ-2 (26.2%) at the start of rehabilitation. Both measures showed a significant decline in depression rates after rehabilitation. Twelve months after the end of pulmonary rehabilitation, the proportion of patients with depression was still lower than at therapy initiation. Although mean changes were low for all patients, they were high for patients with clinically relevant depression at baseline according to the results of both the PHQ-9 and PHQ-2. Reliability was high for both PHQ-9 (composite reliability=0.94) and PHQ-2 (composite reliability=0.89) The investigators note that the study has several limitations. As this is a secondary analysis of a study with other primary research questions, no gold standard to assess depression was used, and the diagnostic accuracy of both PHQ-2 and PHQ-9 is not clear. Furthermore, there were few patients in the GOLD-IV group, so the GOLD-III and GOLD-IV groups were combined for this analysis. Nonetheless, the researchers conclude that the PHQ-9 demonstrated good factorial validity, high reliability, as well as measurement invariance among patient groups and time points. They suggest that future studies should examine the diagnostic accuracy for both instruments in patients with COPD. www.psychiatryadvisor.com/depression-advisor/inpatient-rehabilitation-assessment-depression-chronic-obstructive-pulmonary-disease/article/756290/
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Post by jarca on Apr 12, 2018 23:04:32 GMT -5
hmmmm, when i went to my PCP last week he had me take the 2nd test. He said he had all patients do it once a year.
Ironically, I had just gone over the changes I have had with #3,4,5,7 & 8 since my thyroid & 02 levels have been down this past year. Had I taken that test before having bloodwork; many dr's would have diagnosed me as depressed & put me on an anti-depressant medication. Meanwhile, my physical problem may not have been addressed. I feel that it is important to watch for depression with chronic pain or illness, but i do hope that more than just that written test is given before any definitive diagnosis of depression is made.
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Post by gerald on Apr 13, 2018 0:05:33 GMT -5
It is unfortunately that the doctors appointments are so brief these days. There was a time when the Doctor would have a conversation to pick up cues on a persons mental state, state of well being, emotional state. That is one thing we have lost.
The questionnaire may be a start but it would only be a start in identifying depression. And many people either will not recognise their depression or will not feel comfortable acknowledging it to anyone.
It is a difficult trying to get doctors to investigate problems anyways and not just state that "it is all in your mind". Not sure how we find a balance.
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Post by joany on Apr 13, 2018 7:35:08 GMT -5
Very important informatiion. We, in general, are reluctant to acknowledge depression. I went round- about with it. Who me?! I've read some posts within this forum when the contributor is obviously depressed. Hopefully this article will be read and proper support initiated.
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Post by skate4life on Apr 13, 2018 10:23:46 GMT -5
There are different kinds of depression. It is common in COPD and it can wax and wane over time. Some can be helped with regular exercise. A counselor may be needed if it really interferes with your life. Some have had an underlying depression for years and it gets exacerbated with COPD. Many docs are too quick to order antidepressant medications. I just read a review that said these drugs usually are not needed with the classic COPD depression. An appropriate counselor can be a big help. As noted, docs really don't have much time to listen anymore.... Obviously if someone does exhibit severe depression then help should be sought.
I never had any of these tests......and of course you can always lie.
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Post by joany on Apr 13, 2018 17:20:58 GMT -5
Depression is a difficult subject as there's a tendency to whisper about it. But it's important to recognize that it too could be a factor with COPD. For me, when I lack energy, I lack motivation which leads to "not feeling good" about myself since I don't even do the simplest thing. I recognized the pattern - a day at a time and I'm okay.
There are several options which help, with the first being - with no harm, no foul - be true to yourself and then be true to someone else or a counselor.
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Post by lavishgail on Apr 14, 2018 20:43:17 GMT -5
As with any type of disease, it's only natural to be somewhat depressed, I mean look how different we live now? Really, I highly doubt anyone is jumping for joy with any type of illnesses! I know I'm not thats for sure! I take an antidepressant one each day at a very small mg, for what I take, when the doctor asks me she says, ate u taking you're baby pill? . Without my pill, I'm not good!😣 with it I'm 😊 I have to push myself to do anything, and always bad news about my health tends to bring me down, but I keep on keeping on!! I have too. Good day..
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