Am. J. Respir. Crit. Care Med., Volume 163, Number 2, February 2001, 329-334

Depression in Sarcoidosis

BETTY CHANG, JOANNE STEIMEL, DAVID R. MOLLER, ROBERT P. BAUGHMAN, MARC A. JUDSON, HENRY YEAGER Jr., ALVIN S. TEIRSTEIN, MILTON D. ROSSMAN, and CYNTHIA S. RAND

Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland; Pulmonary and Critical Care Medicine, University of Cincinnati, Cincinnati, Ohio; Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina; Division of Pulmonary and Critical Care Medicine, Georgetown University, Washington, DC; Division of Pulmonary and Critical Care Medicine, Mount Sinai Medical Center, New York, New York; and Pulmonary and Critical Care Division, University of Pennsylvania, Philadelphia, Pennsylvania

Sarcoidosis, a chronic, multisystem disease, impacts quality of life and may increase depression risk. No previous study has reported the depression prevalence among U.S. sarcoid patients. This cross-sectional study examined sociodemographic and disease morbidity factors associated with depression. Patients diagnosed for  1 yr and treated at one of six centers were eligible (n = 176); 154 completed a questionnaire of demographics, treatment, access to medical care, and a short-form Center for Epidemiologic Studies Depression Scale (CES-D). The primary outcome variable was a CES-D score of  9, indicating clinical depression. The prevalence of depression was 60%. Gender, income, access to medical care, dyspnea on exertion, and number of systems involved were associated with depression. Female sex, decreased access to medical care, and increased dyspnea predicted depression (odds ratio [OR] = 3.33, 11.64, and 2.78, respectively) after adjusting for race, income, and steroid therapy. Despite tertiary care access, patients reported medical care limitation. Health care providers must be sensitive to multiple barriers faced by chronic sarcoid patients; acknowledging depression risk and improving access to medical care will promote better overall health among sarcoid patients. Future studies of sarcoidosis will need to address depression diagnosis and treatment.

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