Vitamin D deficiency, fatigue, and persistent cough as independent predictors of depressive symptoms in sarcoidosis patients

Branislav Gvozdenovic; Violeta Mihailovic-Vucinic; Mira Vukovic; Maja Omcikus; Jelena Cvejic; Slobodan Belic; Jelena Jankovic; Natasa Djurdjevic; Mihailo Stjepanovic

doi:10.5937/jomb0-54015

Branislav Gvozdenovic PPD Serbia, Part of Thermo Fisher Scientific, Pharmacovigilance Department, Belgrade
Violeta Mihailovic-Vucinic MediGroup General Hospital, Belgrade, Serbia
Mira Vukovic Health Center Valjevo, QA Department, Serbia https://orcid.org/0000-0002-3662-5374
Maja Omcikus School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Jelena Cvejic Clinic for Pulmonary Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Slobodan Belic School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Jelena Jankovic School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, University Clinical Center of Serbia, Belgrade, Serbia https://orcid.org/0000-0001-8529-8624
Natasa Djurdjevic School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, University Clinical Center of Serbia, Belgrade, Serbia
Mihailo Stjepanovic School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, University Clinical Center of Serbia, Belgrade, Serbia https://orcid.org/0000-0003-1787-1438

DOI: https://doi.org/10.5937/jomb0-54015

Keywords: Sarcoidosis, Depressive Symptoms, Vitamin D deficiency, Fatigue, Cough, Multivariate analysis

Abstract

Background: Depressive symptoms are frequent in sarcoidosis. We assessed the impact of sarcoidosis symptoms, pulmonary function, fatigue, radiographic findings, comorbidities, treatment, and serum levels of 25-hydroxyvitamin D (25(OH)D) on depressive symptoms in sarcoidosis patients.

Methods: In a cross-sectional study we measured depressive symptoms with the Center for Epidemiologic Studies – Depression Scale (CES-D) and fatigue by Fatigue Assessment Scale (FAS). Presence of depressive symptoms was defined with CES-D scores ≥16 and ≥20, respectively. Fatigue was defined with FAS score ≥22.

Results: A total of 400 patients were included in the study. CES-D score ≥16 had 128 patients, while CES-D score ≥20 had 86 patients. In a multivariate binomial logistic regression model, the following independent predictors of CES-D score ≥16 were identified: female gender (odds ratio, OR 1.983), chronic sarcoidosis (OR 2.311), serum levels of 25(OH)D ≤20 ng/mL (OR 2.326), persistent dry cough (OR 2.173), FAS Scores ≥22 (OR 9.243), and chest X-ray stage 3 (8.851). Five variables were independent predictors of CES-D score ≥20: diplopia (OR 4.411), FEV₁ <80% predicted associated with FVC <80% predicted (OR 2.311), serum levels of 25(OH)D ≤20 ng/mL (OR 2.278), persistent dry cough (OR 3.001), and FAS Scores ≥22 (OR 7.611).

Conclusions: Measuring the contribution of low serum 25-hydroxyvitamin D and the impact of persistent dry cough on depressive symptoms in patients with sarcoidosis may be crucial in deciding whether to use vitamin D₃ alone or with antitussive therapy before the psychiatric diagnosis of depression with antidepressant therapy initiation.

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