ntroduction Depression often occurs in patients with chronic obstructive pulmonary disease (COPD) [1]. In stable COPD, the prevalence of clinical depression ranges between 10 and 42%. The risk of depression is higher in patients with severe COPD compared with control participants, with the highest rates, up to 62%, found in oxygen-dependent patients [2]. Patients with COPD may have a spectrum of symptoms ranging in severity from short-term depressive symptoms to dysthymia (long-term chronic symptoms that are not disabling) to clinical depression. A few studies have reported that approximately two-thirds of COPD patients with depression have moderate-to-severe depression. However, the prevalence of minor or subclinical depression may be even higher in this population, assuming that it is similar to other chronic illnesses. Depression is often untreated or undertreated in patients with COPD [3]. Untreated or incompletely treated depression has major implications for compliance with medical treatment, increased frequency of hospital admissions, prolonged length of stay, and increased consultations with primary care physicians; lack of treatment is also associated with poor quality of life and premature death [4].