Gender Differences in Risk Factors for Depressive Symptoms in Patients with COPD: The 2014 and 2016 Korea National Health and Nutrition Examination Survey

Abstract Background: Although depression is a common comorbidity of chronic obstructive pulmonary disease (COPD), the role of gender remains unexplored. We evaluated gender differences of risk factors of depressive symptoms in adults with COPD. Methods: This was a population-based cross-sectional study using data from the 2014 and 2016 Korea National Health and Nutrition Examination Survey. Spirometry was used to identify patients with COPD, defined as a FEV1/FVC ratio <0.7. Presence of depressive symptoms was defined as a total score ≥5 on the Patient Health Questionnaire-9. Results: Overall, 17.8% of participants expressed depressive symptoms, with 13.1% being men and 29.6% being women. Multivariable regression analysis revealed that low BMI (adjusted OR, 2.62), female gender (adjusted OR, 3.48), living alone (adjusted OR, 1.75), currently smoking (adjusted OR, 2.52), and GOLD Stage III/IV (adjusted OR, 2.34) were significant risk factors for depressive symptoms. In a subgroup analysis, low BMI, low income, living alone, and multiple chronic disorders were risk factors of depressive symptoms in men, whereas low educational attainment, urban living, and currently smoking were risk factors in women.Conclusions: As risk factors of depressive symptoms in COPD patients vary according to gender, different approaches are needed to manage depression in men and women with COPD.