High prevalence of depressive symptoms and its impact on quality of life in patients with Mycobacterium avium complex lung disease.

BACKGROUND

Depression is a known complication of various chronic diseases; however, its prevalence in patients with Mycobacterium avium complex lung disease (MAC-LD) remains unclear. Although patients with MAC-LD have an impaired health-related quality of life (HrQoL), previous studies on HrQoL have lacked an assessment of depressive symptoms, which could be associated with HrQoL.

OBJECTIVE

We investigated the prevalence of depressive symptoms in patients with MAC-LD to assess whether depressive symptoms are related to HrQoL and examined factors associated with the presence of depressive symptoms.

METHODS

We cross-sectionally enrolled outpatients with MAC-LD attending Kyoto University Hospital who had no treatment changes or hospitalizations for at least 3 months before enrollment. Depressive symptoms were assessed using Patient Health Questionnaire-9 (PHQ-9). A PHQ-9 score of ≥5 indicated depressive symptoms, and a score of ≥10 indicated more severe depressive symptoms. HrQoL was evaluated using the 36-Item Short Form Health Survey and St. George's Respiratory Questionnaire.

RESULTS

Among the 100 enrolled patients with MAC-LD, 35 (35%) had a PHQ-9 score ≥5 and 8 (8%) had a score ≥10. The total SGRQ score was significantly associated with dyspnea, cough, C-reactive protein level, and PHQ-9 score (p < 0.0001, <0.0001, p = 0.013, and p = 0.035, respectively). Depressive symptoms were associated with severe fatigue and family history of psychiatric diseases.

CONCLUSION

Depressive symptoms were highly prevalent among patients with MAC-LD, and the HrQoL of patients with depressive symptoms was worse than that of patients without depressive symptoms. Healthcare-providers should carefully assess patient symptoms to avoid overlooking coexisting depressive symptoms.