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Depression in patients with chronic obstructive pulmonary disease (COPD) can be an incapacitating health problem that negatively affects the quality of life. If the depression is not treated, it is associated with increased morbidity and mortality. The goal of this study was to determine the frequency of depression in patients with COPD and examine the factors contributing to depression in these patients.  Methods  This cross-sectional study was conducted using a sample of 556 patients with COPD visiting the Pulmonology Clinic of the Aga Khan University Hospital in Karachi, Pakistan, from March 2010 to March 2011. A pretested structured questionnaire was used for data collection. The Hospital Anxiety and Depression Scale (HADS) was used to screen for depression. SPSS Statistics for Windows, Version 19.0. (IBM Corp, Armonk, NY) was used to enter and analyze data.  Results  Out of the total 556 participants, majority 62.9% were between 60 and 79 years of age and 70.1% of the participants were males. The frequency of depression in COPD patients was 57.2%, and multiple logistic regression analyses indicated being over 59 years (Adjusted odds ratio (ORadj), 2.750; 95% confidence interval [CI]: 1.25 to 6.05, p = 0.039), being male (ORadj, 2.28; 95% CI: 0.89 to 5.14), being retired or unemployed (ORadj, 1.041; 95% CI: 0.41 to 2.62, p = 0.000), using inhaled steroids (ORadj, 3.929; 95% CI: 2.59 to 5.97, p = 0.000), and living alone were significantly associated with depression in COPD patients.  Conclusion  Several risk factors for depression in patients with COPD were identified. Patients with COPD who are elderly, male, retired or unemployed, use inhaled steroids, and patients who live alone have characteristics significantly associated with depression. These factors should be considered by practicing family physicians, pulmonologists, and healthcare workers.

Depression and its Associated Factors among Patients with Chronic Obstructive Pulmonary Disease in Karachi, Pakistan