The relationship of depression in asthma–chronic obstructive pulmonary disease overlap syndrome

<div><p>Purpose</p><p>To clarify the relationship between asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS) and depression.</p><p>Methods</p><p>We identified 10,911 patients who received an ACOS diagnosis and concurrent treatment between January 2000 and December 2009. Subjects without ACOS were included in the non-ACOS cohort (<i>n</i> = 10,911). Cox proportional hazard regression analysis was performed to compare the risk of depression between the ACOS and non-ACOS cohorts.</p><p>Results</p><p>The risk of depression was higher in the ACOS cohort than in the non-ACOS cohort (adjusted hazard ratios (aHRs) = 1.67, 95% confidence interval [CI] = 1.48–1.88). In the ACOS cohort, the aHRs for depression were [2.44 (95% CI = 1.45–4.11); 2.36 (95% CI = 1.58–3.52)] in patients [aged 20–39 years; without comorbidity]. In the ACOS cohort, the aHRs for depression were 1.70 (95% CI = 1.51–1.93) and 1.84 (95% CI = 1.55–2.19) in patients without inhaled corticosteroids (ICSs) and oral steroids (OSs) use, respectively. Moreover, the aHRs for the risk of depression were 1.16 (95% CI = 0.95–1.41) and 1.12 (95% CI = 0.96–1.29) in patients with ICSs and OSs use, respectively.</p><p>Conclusion</p><p>The risk of depression is higher in ACOS patients, even in those without comorbidities or in young adults. The events of the depression were not significant difference in patients receiving the ICSs/OSs between the ACOS and the non-ACOS cohorts.</p></div

Adjusted hazard ratio for depression in the ACOS patients with and without ICSs and OSs use during the follow-up period.

<p>Adjusted hazard ratio for depression in the ACOS patients with and without ICSs and OSs use during the follow-up period.</p

Effect of Systemic Lupus Erythematosus on the Risk of Incident Respiratory Failure: A National Cohort Study

<div><p>Purpose</p><p>We conducted a nationwide cohort study to investigate the relationship between systemic lupus erythematosus (SLE) and the risk of incident respiratory failure.</p><p>Methods</p><p>From the National Health Insurance Research Database, we identified 11 533 patients newly diagnosed with SLE and 46 132 controls without SLE who were randomly selected through frequency-matching according to age, sex, and index year. Both cohorts were followed until the end of 2011 to measure the incidence of incident respiratory failure, which was compared between the 2 cohorts through a Cox proportional hazards regression analysis.</p><p>Results</p><p>The adjusted hazard ratio (aHR) of incident respiratory failure was 5.80 (95% confidence interval [CI] = 5.15–6.52) for the SLE cohort after we adjusted for sex, age, and comorbidities. Both men (aHR = 3.44, 95% CI = 2.67–4.43) and women (aHR = 6.79, 95% CI = 5.93–7.77) had a significantly higher rate of incident respiratory failure in the SLE cohort than in the non-SLE cohort. Both men and women aged <35 years (aHR = 31.2, 95% CI = 21.6–45.2), 35–65 years; (aHR = 6.19, 95% CI = 5.09–7.54) and ≥65 years (aHR = 2.35, 95% CI = 1.92–2.87) had a higher risk of incident respiratory failure in the SLE cohort. Moreover, the risk of incident respiratory failure was higher in the SLE cohort than the non-SLE cohort, for subjects with (aHR = 2.65, 95% CI = 2.22–3.15) or without (aHR = 9.08, 95% CI = 7.72–10.7) pre-existing comorbidities. In the SLE cohort, subjects with >24 outpatient visits and hospitalizations per year had a higher incident respiratory failure risk (aHR = 21.7, 95% CI = 18.0–26.1) compared with the non-SLE cohort.</p><p>Conclusion</p><p>Patients with SLE are associated with an increased risk of incident respiratory failure, regardless of their age, sex, and pre-existing comorbidities; especially medical services with higher frequency.</p></div

Adjusted HR of incident respiratory failure associated with the annual frequency of outpatient visits and hospitalizations because of SLE exacerbation.

<p>Adjusted HR of incident respiratory failure associated with the annual frequency of outpatient visits and hospitalizations because of SLE exacerbation.</p

Cumulate incidence of incident respiratory failure between the SLE and non-SLE cohorts, obtained using the Kaplan–Meier model.

<p>Cumulate incidence of incident respiratory failure between the SLE and non-SLE cohorts, obtained using the Kaplan–Meier model.</p

Incidence and adjusted HR of incident respiratory failure between the non-SLE and SLE cohorts, stratified by comorbidity type.

<p>Incidence and adjusted HR of incident respiratory failure between the non-SLE and SLE cohorts, stratified by comorbidity type.</p

Incidence and adjusted hazard ratio of incident respiratory failure between non-SLE and SLE cohorts by propensity score matching.

<p>Incidence and adjusted hazard ratio of incident respiratory failure between non-SLE and SLE cohorts by propensity score matching.</p

HR of depression in Association with Sex, Age, and Comorbidities in Univariable and Multivariable Cox Regression Models.

<p>HR of depression in Association with Sex, Age, and Comorbidities in Univariable and Multivariable Cox Regression Models.</p

Cumulative incidence of depression in the ACOS (dashed line) and non-ACOS cohorts (solid line).

<p>ACOS, asthma–COPD overlap syndrome; COPD, chronic obstructive pulmonary disease.</p

Risk of depression between the ACOS and non-ACOS cohorts stratified by sex, age, and comorbidity (no/yes).

<p>Risk of depression between the ACOS and non-ACOS cohorts stratified by sex, age, and comorbidity (no/yes).</p