Early Treatment Of Depression Research Articles

A network approach to investigating the inter-relationship between health-related quality of life dimensions and depression in 1735 Chinese patients with heterogeneous cancers.

We aimed to explore the inter-connection between depression and HRQOL dimensions in cancer patients using a network approach, which might provide new insights for precise interventions to improve cancer patients' overall HRQOL. Between June 1, 2016, and August 31, 2017, a total of 1735 eligible patients with heterogeneous types of cancer were recruited. The Zung Self-Rating Depression Scale (SDS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were used to measure patients' depression status and HRQOL, respectively. A regularized partial correlation network was established. Central and bridge symptoms/functions were identified using expected influence and bridge expected influence. A directed acyclic graph (DAG) was used to explore the possible causal relationship between depression and HRQOL dimensions. In this study, depression and 15 dimensions of the EORTC-QLQ-C30 scale were highly inter-correlated and could be represented as a network. We found that nearly two-thirds of cancer patients experienced various degrees of depression, and depression was consistently the central symptom in the network, in addition to nausea/vomiting, pain, and physical function. DAG and bridge symptoms indicated that depression might influence overall HRQOL in cancer patients mainly through emotional function, pain, physical function, and sleeplessness, particularly in cancer patients with moderate-to-severe depression. The disparity in network structures between mild and moderate-to-severe depression suggested that the relationship between depression and HRQOL dimensions might be bidirectional. The prevalence of depression remained high in Chinese patients with cancer, and depression may influence various symptoms and functions within the HRQOL network. Screening and early treatment of depression were warranted to improve the overall HRQOL of cancer patients, in addition to adequate treatment of pain and nausea/vomiting and improvement in physical function.

Development of depression assessment tools using humanoid robots -Can tele-operated robots talk with depressive persons like humans?

BackgroundDepression is a common mental disorder and causes significant social loss. Early intervention for depression is important. Nonetheless, depressed patients tend to conceal their symptoms from others based on shame and stigma, thus hesitate to visit psychiatrists especially during early phase.We hypothesize that application of humanoid robots would be a novel solution. Depressed patients may feel more comfortable talking with such robots than humans. MethodsWe recruited 13 patients with major depressive disorder (MDD) and 27 healthy volunteers as controls. Participants took both tele-operated humanoid robot and human interviews to evaluate severity of depression using the Hamilton Depression Rating Scale (HDRS). In addition, participants completed a self-administered questionnaire asking about their impressions of the robot interview. ResultsConfidence interval and t-test analysis have revealed that the HDRS scores are equally reliable between robot and human interviews. No significant differences were observed between the two interviews regarding “nervousness about the interview” and “hesitancy to talk about depressed moods and suicidal ideation.” Compared to human interviews, robot interviews yielded significantly lower scores on shame-related factors especially among patients with MDD. LimitationSmall sample size, and the evaluator is male only. ConclusionsThis is the first report to show the reliability of tele-operated humanoid robot interviews for assessment of depression. Robot interviews are potentially equally reliable as human interviews. Robot interviews are suggested to be more appropriate in assessing shame-related suppressed emotions and hidden thoughts of depressed patients in clinical practice, which may reduce the stigma associated with depression.

The role of mindfulness on the psychological aspects of anorexia nervosa.

Emotion regulation, perfectionism, and rumination are perpetuating factors in anorexia nervosa (AN). Mindfulness can be protective and therapeutic. We aimed to understand the relationship between these factors and mindfulness in AN. 20 adolescent girls in the acute phase of the AN, 16 in remission, and 40 in the control group were evaluated. Mindfulness was lowest in the acute AN group. The difference in the acute AN group regarding body dissatisfaction, emotion dysregulation, perfectionism, and mindfulness disappeared after controlling for the effects of depression and anxiety. The predictors of disordered eating in the entire study population were body dissatisfaction and depressive symptoms. Emotion regulation and perfectionism were the predictors of mindfulness in the acute AN group and the entire study population. When mindfulness decreased, concerns about body shape increased in both acute AN and remission groups, while dietary restriction and disordered eating behaviors increased only in the remission group. Emotion regulation difficulties in acute AN could be related to depression and anxiety. Mindfulness interventions for emotion regulation could be used for depression during the acute phase while for perfectionism in remission. Early intervention for depression and body dissatisfaction seems protective, and mindfulness could be an appropriate intervention.

Association between solid cooking fuel use and dementia in older Chinese adults: the mediating effect of depression

ABSTRACT This study aimed to explore the association between household solid cooking fuel use and dementia prevalence and the mediating effect of depression on this association. A total of 3404 (2018) and 1379 (2015 to 2018) older participants (≥65) from the China Health and Retirement Longitudinal Study (CHARLS) were enrolled in the cross-sectional and retrospective longitudinal analyses, respectively. The results showed that solid cooking fuel use was associated with an increased dementia prevalence (adjusted OR = 1.44) from 2015 to 2018. The indirect effect of depression on this association explained 7.14% and 13.11% variances in the cross-sectional and longitudinal mediating model, respectively. Thus, household solid cooking fuel use is a risk factor for the development of dementia, and depressive symptoms partially accounted for this association. The use of improved cookstoves and clean fuel in households and air cleaners and early intervention in depression may reduce the incidence of dementia.

A novel automated depression detection technique using text transcript

AbstractDepression is one of the most common mental illnesses, impacting billions of people worldwide. The lack of existing resources is impeding the country's economic prosperity. As a result, new approaches for detecting and treating mental diseases as well as reaching out to individuals are required so that people can overcome their daily challenges and become more productive. An automated depression detection system can greatly aid in clinical findings and early treatment of depression. Automatic detection, like in a clinical interview can be derived from various modalities that include video, audio, and text. Among these modalities, audio characteristics are the most commonly researched while text elements are seldom investigated. In the light of the above, this paper proposes a novel automated depression identification approach based on linguistic material gathered from patient interviews. The focus is to enhance both the accuracy and efficiency of detection. The proposed approach is made up of two parts: a Bidirectional Gated Recurrent Unit (BGRU) network for dealing with linguistic information and a fully coupled network that integrates the model outputs to measure the depressed state. The proposed approach is validated using Distress Analysis Interview Corpus‐Wizard‐of‐Oz interviews dataset. To evaluate the performance precision, recall, and F1 score are computed using the proposed approach and then the comparative analysis is done with the existing approaches. The proposed approach yielded an F1 score of 0.92, indicating the existence of depression as well as the projected severity level. It is realized from the generated results that the proposed approach has outperformed the previous ones. The proposed approach can not only automatically assess the severity of depression but also enhances both the accuracy and efficiency of detection. The proposed approach indicates the feasibility of BGRU over Long Short Term Memory by achieving exceptional results for recognition of depression.

The role of depression and physical activity in the association of between sleep quality, and duration with and health-related quality of life among the elderly: a UK Biobank cross-sectional study

BackgroundAlthough studies have shown that sleep quality (duration) is associated with health-related quality of life (HRQoL), most of these studies have been small-sized and targeted at young and middle-aged adults. In addition, few studies have explored the path mechanism of sleep disorders leading to impaired HRQoL.ObjectivesThis study aimed to determine the association between sleep quality and duration and HRQoL among the elderly in the United Kingdom, assess whether depression mediated the association, and explore the role of physical activity (PA) in the path association.MethodsData were extracted from the baseline survey of the UK Biobank, a large prospective cohort study enrolling more than 500,000 participants, of which 52,551 older adults (aged ≥60 years) were included in the study. HRQoL was assessed using the European Quality of Life-5 Dimensions. Tobit and multivariate logistic regression models were used to determine the association between sleep quality and duration and HRQoL. The mediating and moderated mediation models were estimated using the PROCESS macro and MEDCURVE macro.ResultsThe Tobit model showed that the elderly with short or long sleep duration (β = − 0.062, 95% confidence interval [CI] = − 0.071 to − 0.053; β = − 0.072, 95% CI = − 0.086 to − 0.058) had worse HRQoL after adjusting potential covariates. In the logistic regression models, we found an inverted U-shaped association between sleep duration and HRQoL. Moreover, a significant positive association was observed between sleep quality and HRQoL (all P < 0.05). The results also revealed that depression mediated the association between sleep disorders and HRQoL (sleep quality: β = 0.008, 95% CI = 0.007–0.010; sleep duration: θ = 0.001 [mean], 95% CI = 0.001–0.002). Furthermore, PA moderated all paths among sleep quality and duration, depression, and HRQoL, and greater effects were observed in the elderly with lower PA levels.ConclusionsThe findings show that poor sleep quality and duration were independently associated with worse HRQoL among the elderly in the United Kingdom. Furthermore, PA buffers the mediating effect of depression and adverse effects of sleep disorders on HRQoL. It is essential to properly increase PA and provide early intervention for depression in the elderly with sleep disorders to improve their HRQoL.

Reciprocal relationship between multicultural adolescents’ depression and life satisfaction: a random intercept cross-lagged panel model for 3-wave panel data

Multicultural adolescents (MA) in Korea experience higher depression and lower life satisfaction compared to Korean native adolescents. To consider appropriate interventions, this study investigates the cross-lagged effect between life satisfaction and depression among these adolescents. Secondary data from the Multicultural Adolescents Panel Survey, which is a nationally representative sample, was analyzed. Data from the 3rd (T1, elementary school), 5th (T2, middle school), and 7th (T3, high school) waves (2013–2017) were used. Altogether, 1,239 MA were included in the sample for analysis; the mean age at T1 was 11.97 (± 0.36) years. The ten-item Depression Scale Questionnaire was used to measure depression, and the three-item Happiness Scale was used to measure life satisfaction. The random intercept cross-lagged panel model was conducted to estimate within-person autoregressive and cross-lagged effects. Life satisfaction and depression had a reciprocal relationship from T1 to T2, while only life satisfaction had a lagged effect from T2 to T3. Life satisfaction’s lagged effect dominated that of depression. The cross-lagged effect size of depression from T1 to T2 was larger than that from T2 to T3, and that of life satisfaction from T2 to T3 was larger than that from T1 to T2. Low life satisfaction in MA continues over time. Depression is not persistent, but if experienced in elementary school, it leads to low life satisfaction in middle school and depression in high school. The findings suggest that early intervention for depression in elementary school can reduce its negative effect MA’s life satisfaction.

Feasibility and Acceptability of "Cuida tu Ánimo" (Take Care of Your Mood): An Internet-Based Program for Prevention and Early Intervention of Adolescent Depression in Chile and Colombia.

The rapid internet penetration in Latin American countries has made it possible to implement digital mental health interventions. “Cuida tu Ánimo” (Take Care of Your Mood) is an internet-based program for the prevention and early intervention of depression in adolescents. A pilot study was conducted in Chile and Colombia to study the feasibility and acceptability of the program and estimate its effects. There were 199 participants (53.3% women; mean age = 14.8 years, SD = 1.0) recruited from two schools in Chile and two schools in Colombia. Qualitative and quantitative methods were applied for data collection and analyses. Although the levels of acceptance were moderate to high across all variables, adherence was lower than expected. The participants deemed important for an intervention of this type offered a higher level of interaction with team members through internet-based and face-to-face activities. Post-intervention outcomes show a reduction in depressive and anxious symptoms in adolescents in Chile, while there were no significant changes in the level of symptomatology in adolescents in Colombia. The women used the program more than the men. Results show the need to improve the intervention by increasing its levels of customization and developing strategies to achieve better adherence. The contradictory results of the program in Chile and Colombia suggest the importance of other variables beyond the content of the intervention, such as the setting or context of the intervention.

Updates in treatment of depression in children and adolescents.

To examine recent evidence that informs the treatment of depression in children and adolescents. There are no new leads in the prevention and early intervention of depression in children and adolescents. For acute treatment of major depressive disorder, talking therapies are moving increasingly to internet-based platforms. Family therapy may have a slight edge over individual psychotherapy in the short-term. Patients with severe depression with endogenous features have a more robust response to pharmacotherapy than do patients with mild-to-moderate depression. Findings in relation to reward sensitivity and changes in brain-derived neurotrophic factor levels contradict research conducted in adults, suggesting developmental differences in the mechanisms underlying depression. Ketamine infusion could have a role for adolescents with treatment refractory depression. There was no new evidence concerning relapse prevention. Most new findings have been concerned with moderators and mediators of treatment.

Using Imagery Rescripting as an Early Intervention for Depression in Young People.

Innovation is urgently needed for school-based early interventions for depression. Imagery rescripting for aversive memories has been shown to be a valuable therapeutic approach in adults. Yet it is rarely applied to young people or to depression. This is surprising given that intrusive images of aversive memories are implicated in the development and maintenance of depression. We review the literature and describe the co-development of an imagery rescripting protocol for young people (age 16–18) with high symptoms of depression. To contextualize and illustrate this approach, we identify three themes of negative images emerging from the 37 participants who completed imagery rescripting and provide a detailed case example for each theme. The identified themes are failure, interpersonal adversity, and family conflict or disruption. Given that there is some therapist concern about using imagery rescripting, we highlight any reported negative consequences of engaging in imagery rescripting. We propose that imagery rescripting is an acceptable and potentially effective tool for early intervention in depression, which is significantly underutilized in current practice.

Depression among attendants of the Sudanese National Association of the Blinds in Khartoum, Sudan

BackgroundBlindness has profound consequences for the victim, family, and society. The impact of vision loss on daily life activities could lead to psychological stress. Early treatment of depression may reduce the added disability that is associated with vision loss. This study aimed to assess the extent and associated factors with depression among the Sudanese blind people in Khartoum, Sudan. A cross-section facility-based study was conducted, in which depression among the participants was assessed using the Beck Depression Inventory Scale. A chi-square test was implemented to determine the relationship between categorical variables and the significance level for all analyses was set at p < 0.05.ResultsA total of 185 participants were included in the study. Out of them, 84.3% were male and near half of the participants (42.2%) were born blind. The prevalence of depression among the participants was 11.4%. There were significantly higher rates of depression in those who were illiterate (χ2 = 6.233, p = 0.044) and in those whose loss of vision was due to accidents or traumatic causes and loss of vision due to accidents or traumatic causes (χ2 = 12.840, p = 0.002). There was significantly lower rate of depression in those who were born with blindness compared to others (χ2 = 10.504, p = 0.005).ConclusionsPeople who were born blind have a lower rate of depression and people who lost their sight due to trauma have a higher rate of depression, and therefore, requiring more psychiatric support. Despite the relatively low percentage of depression, establishing programs for early identification and combating depression among the blind population in our setting is highly recommended.

Predicting Neuroimaging Biomarkers for Antidepressant Selection in Early Treatment of Depression.

Due to the biological heterogeneity, 60%-70% of patients with major depressive disorder (MDD) do not respond to or achieve remission from first-line antidepressants. Predicting neuroimaging biomarkers for early antidepressant treatment could guide initial antidepressant therapy. To assess for neuroimaging biomarkers for antidepressant selection in early antidepressant treatment. Prospective. A total of 85 MDD patients from the major site and 33 MDD patients from an out-of-sample test site. A 3.0 T, T1-weighted imaging using a magnetization-prepared rapid acquisition gradient-echo sequence and diffusion tensor imaging (DTI) using an echo-planar sequence. Baseline DTI data of patients who achieved early improvement after 2-weeks of antidepressant treatment (selective serotonin reuptake inhibitors [SSRI] or serotonin-norepinephrine reuptake inhibitors [SNRI]) were analyzed. An ensemble model was constructed using data from the major site and then applied to assess the early response of patients at the out-of-sample test site. Support vector machine combined with leave-one-out cross-validation were applied to construct the whole model from individual base models from different brain regions. Discriminative biomarkers were evaluated by calculating the changes in sensitivity and specificity obtained when removing a single base model from the whole model, the base model being removed changing in each run. Training performance over MDD patients at the major site achieved 75% accuracy while performance with accuracy of 70% was achieved in the out-of-sample test site. Assessing sensitivity and specificity changes following the removal of single base models from the prominent model highlighted the functions of two neural circuitries: SSRI-related emotion regulation circuitry, centered on the hippocampus (sensitivity changes: 10%) and amygdala (sensitivity changes: 11%); and SNRI-related emotion and reward circuitry, centered on the putamen (specificity changes: 8%) and orbital part of superior frontal gyrus (specificity changes: 12%). These findings support future research on clinical antidepressant selection for MDD. 1 TECHNICAL EFFICACY: Stage 2.

Towards Automatic Depression Detection: A BiLSTM/1D CNN-Based Model

Depression is a global mental health problem, the worst cases of which can lead to self-injury or suicide. An automatic depression detection system is of great help in facilitating clinical diagnosis and early intervention of depression. In this work, we propose a new automatic depression detection method utilizing speech signals and linguistic content from patient interviews. Specifically, the proposed method consists of three components, which include a Bidirectional Long Short-Term Memory (BiLSTM) network with an attention layer to deal with linguistic content, a One-Dimensional Convolutional Neural Network (1D CNN) to deal with speech signals, and a fully connected network integrating the outputs of the previous two models to assess the depressive state. Evaluated on two publicly available datasets, our method achieves state-of-the-art performance compared with the existing methods. In addition, our method utilizes audio and text features simultaneously. Therefore, it can get rid of the misleading information provided by the patients. As a conclusion, our method can automatically evaluate the depression state and does not require an expert to conduct the psychological evaluation on site. Our method greatly improves the detection accuracy, as well as the efficiency.

Depression and risk of atrial fibrillation: a nationwide population-based study

Abstract Background Although treatments of atrial fibrillation (AF) based on the biological mechanisms for initiation and maintenance of AF improve cardiovascular outcomes, psychosocial factors have been also implicated in the etiology and progression of cardiovascular disease. Objective We aimed to evaluate the association between depression and incident AF using nationwide database from the National Health Insurance Service in South Korea. Methods A total of 9,075,224 participants with data of national health checkup in 2009 were included, and participants who were diagnosed with AF before the examination were excluded. Exposure to depression is determined by the precedence of depression diagnosed within 2 years. Results Depression was diagnosed in 1.37% (124,709) of participants at baseline. Compared to the non-depression group, depression group was likely to be female and had higher comorbidities. After adjusting covariates, depression group had a higher risk of incident AF compared with non-depression group (hazard ratio, 1.30; 95% confidence interval, 1.26–1.34). Repeated exposure to depression increased a risk of incident AF (Figure 1). Conclusion Depression was associated with an increased risk of new-onset AF. This association was stronger for patients who had more burden of depression. Future studies should investigate whether early treatment of depression can prevent incident AF. Figure 1 Funding Acknowledgement Type of funding source: None

Malattia di Alzheimer: una storia antica in ottica moderna

Alzheimer’s disease (AD) involves impairment of the cognitive sphere, motor skills and higher functions, progressive deconstruction of the mind-body system and loss of autonomy. The brain with AD shows extracellular amyloid-β plaques, intraneuronal tangles of hyperphosphorylated tau, and inflammation. The article presents the pathogenesis, the possible prevention and treatment of AD according to the Pnei paradigm: modifiable and unchangeable risk factors are known. Among the formers, a preventive role is assigned to certain behaviors: a correct diet, regular physical activity, the maintenance of significant interpersonal bonds, the control of cardiovascular risk, protection from psychoemotional stress, early treatment of depression and abstention from alcohol and tobacco. The Pnei approach guarantees a systemic look at the clinical-metabolic manifestations of AD (disease), the patient’s experience of illness (illness) and the possibility of residual autonomy (sickness). At present, the study courses on AD created by multidisciplinary teams of professionals, integrated with each other, are increasingly valid.

Sexual Violence Perpetration as a Risk Factor for Current Depression or Posttraumatic Symptoms in Adolescents

Sexual violence perpetration (SVP), including coerced, physically forced, and alcohol- or drug-facilitated unwanted sex, occurs frequently in adolescence and may represent a risk factor for future perpetration. Sexual violence victimization (SVV) has been found to be a risk factor for increased rates of depression and posttraumatic stress disorder (PTSD); however, the associations of SVP with depression or posttraumatic stress symptoms (PTSS) have been less well described. This study examined associations between symptoms of depression and PTSS with SVP in the prior 12 months among high school students. In this cross-sectional analysis, a representative sample of public high school students (ninth-12th grades) completed self-reported surveys on peer SVP and SVV within the past year. Among 16,784 students completing surveys, 7.2% disclosed SVP against another high school student in the past 12 months; 64.4% of students disclosing SVP also experienced SVV. Both SVP and SVV, alone or in combination, were associated with a greater likelihood of symptoms of depression or PTSS. These associations were similar by sex and sexual minority status (e.g., lesbian, gay, bisexual, transgender, and queer [LGBTQ+]). These findings highlight the need for continued primary prevention efforts. Additional screening to recognize adolescent SVP can allow both early treatment of depression and PTSD and address the individual risks of SVP to reduce subsequent repeated sexual assaults.

Incident depression and mortality among people with different types of dementia: results from a longitudinal cohort study.

The aim of this study was to investigate the independent and combined association of incident depression and dementia with mortality and to explore whether the magnitude of the association varies according to different types of dementia, including Alzheimer's disease and vascular dementia. The study was based on a population-based longitudinal cohort consisting of 9940 participants at baseline and followed for over 14years. The sample used for the analyses included 6114 participants with available information on diagnosis of incident dementia and depression. For survival analyses, Cox regression models with incident dementia (n = 293; 5%) and incident depression (n = 746; 12%) as time-dependent variables were used. Cox models adjusted for relevant confounders indicated that comorbidity of incident vascular dementia and incident depression was associated with a much higher mortality risk (HR 6.99; 95% CI 3.84-12.75) than vascular dementia in the absence of depression (HR 2.80; 95% CI 1.92-4.08). In contrast, estimates for comorbidity of Alzheimer's disease and depression were slightly lower than those for Alzheimer in absence of depression (HR 3.56; 95% CI 1.83-6.92 and HR 4.19; 95% CI 2.97-5.90, respectively). Incident depression in the absence of incident dementia was only weakly associated with mortality. These findings indicate that depression and vascular dementia might have synergistic effects on mortality. The results have relevant public health implications for prevention, routine screening for and early treatment of depression among older people, especially those at risk of vascular dementia.

Sleep-wake, cognitive and clinical correlates of treatment outcome with repetitive transcranial magnetic stimulation for young adults with depression

The utility of key phenotypes of depression in predicting response to repetitive transcranial magnetic stimulation (rTMS), namely sleep-wake behaviour, cognition and illness chronicity, has been understudied and not been extended to young samples. This study aimed to determine whether sleep-wake disturbance, cognition or depression chronicity are associated with rTMS outcome in young depressed adults. Sixteen depressed young adults diagnosed with mood disorders (aged 18–29 years) completed this open-label study. Neuronavigationally targeted high-frequency rTMS was administered at 110% of motor threshold on the left dorsolateral prefrontal cortex for 20 sessions over 4 weeks. Clinical, sleep-wake and cognitive assessments were undertaken pre- and post-treatment. Repeated-measures and correlational analyses determined pre- and post-treatment changes and predictors of treatment outcome. rTMS significantly reduced depression and anxiety. Better cognitive flexibility, verbal learning, later age of onset and greater number of depressive episodes were associated with better treatment outcome. There were no other significant/trend-level associations. rTMS had no effect on sleep-wake or cognitive measures. We provide the first evidence for the utility of cognitive flexibility and verbal learning in predicting rTMS outcome in depressed young adults. This research provides preliminary support for rTMS as an early intervention for depression and supports the need for sham-controlled trials.

Detecting Depression Using an Ensemble Logistic Regression Model Based on Multiple Speech Features.

Early intervention for depression is very important to ease the disease burden, but current diagnostic methods are still limited. This study investigated automatic depressed speech classification in a sample of 170 native Chinese subjects (85 healthy controls and 85 depressed patients). The classification performances of prosodic, spectral, and glottal speech features were analyzed in recognition of depression. We proposed an ensemble logistic regression model for detecting depression (ELRDD) in speech. The logistic regression, which was superior in recognition of depression, was selected as the base classifier. This ensemble model extracted many speech features from different aspects and ensured diversity of the base classifier. ELRDD provided better classification results than the other compared classifiers. A technique for identifying depression based on ELRDD, ELRDD-E, was here suggested and tested. It offered encouraging outcomes, revealing a high accuracy level of 75.00% for females and 81.82% for males, as well as an advantageous sensitivity/specificity ratio of 79.25%/70.59% for females and 78.13%/85.29% for males.

Depression is a major determinant of both disease-specific and generic health-related quality of life in people with severe COPD.

The quality of life of patients with chronic obstructive pulmonary disease (COPD) decreases significantly as the disease progresses; those with severe COPD are affected most. This article investigates predictors of the disease-specific and generic health-related quality of life (HRQL) in patients with severe COPD. This multicentre prospective cross-sectional study enrolled 80 patients with severe COPD. At enrolment, all patients completed a disease-specific instrument, the St George’s Respiratory Questionnaire (SGRQ), and a generic instrument, the Short Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson’s correlation and multiple linear regression. The mean age of the patients was 66 ± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity significantly predicted the total SGRQ score (p < 0.05). Depression was the strongest determinant of the total SGRQ score. The SF-36 physical component summary scores were related to depression, dyspnea, and the number of exacerbations (p < 0.05). In comparison, the SF-36 mental component summary scores were related to depression and anxiety (p < 0.05). Depression is a significant determinant of both the disease-specific and generic HRQL in patients with severe COPD. Screening and early intervention for depression in patients with severe COPD could improve the HRQL.