The potential for correction of depressive disorders in patients with chronic obstructive pulmonary disease

Background: The use of vitamin D in the treatment of depressive disorders in patients with chronic obstructive pulmonary disease (COPD) is justified by its pathophysiology, but it is not always feasible in clinical practice. This may be related to the lack of guidelines for implementation for this patient group, as well as to the inadequate sample of patients with baseline high vitamin D levels or mild psychoemotional distress.

Objective: To assess the changes of psychoemotional status over time in COPD patients against the maintenance of vitamin D levels at>34.3 ng/ml for one year.

Materials and methods: The study included 264 COPD patients randomized into the treatment and control groups (135 and 129 patients, respectively). The patients in both groups were divided into 4 subgroups according to their forced expiratory volume in 1 second (FEV1) values and vitamin D levels. All the patients were administered an inactive vitamin D (colecalciferol): in the main group, according to the scheme ensuring maintenance of the micronutrient value above the goal for 12 months, and in the control group according to the standard scheme of correction of vitamin D deficiency. Depression symptoms were assessed in Geriatric Depression Scale (GDS-15) at the beginning of the study and at its end.

Results: After 12 months of vitamin D treatment, the main group showed a statistically significant decrease in the rate of severe depression (14.8% vs 6.7%, χ²=4.67, p=0.04) and an increase in the proportion of patients with normal psychoemotional status (28.2% vs 49.6%, χ²=13.11, p=0.03). In addition, there was a significant difference between the rates of severe depression in the main and control groups after 12 months of treatment: 6.7% vs 14.7% (χ²=4.52, p=0.02).

Conclusion: Maintenance of vitamin D levels above 34.3 ng/ml in COPD patients for 12 months reduces the proportion of patients with severe depression.