Chronic cough is associated with depressive mood in women regardless of smoking status and lung function

Abstract

Background: Chronic cough is a common respiratory symptom, and, if persistent, the patient's quality of life can worsen and result in a depressive mood, or vice versa.Although previous reports suggest a relationship between chronic cough and depression, we further investigated this relationship according to smoking status and lung function. Methods: This observational study used cross-sectional data from the 6 th Korean National Health and Nutrition Examination Survey (2014 and. Propensity score matching using age, sex, smoking status, and lung function was performed for participants with and without chronic cough to reduce the confounding effects associated with depressive mood. Questionnaires recorded coughs persisting for >3 months and the Patient Health Questionnaire-9 (PHQ-9) assessed the severity of depressive mood. Results: Among 12 494 participants who were >18 years old, 226 with chronic cough were matched with 226 with non-chronic cough. Overall, chronic cough participants showed higher PHQ-9 scores than the non-chronic cough participants (4.29 ± 5.23 vs. 2.63 ± 3.38, P < .001). When stratified by sex, the difference remained significant in women (5.69 ± 5.96 vs. 3.05 ± 3.97, P < .001) but not in men (3.18 ± 4.27 vs. 2.31 ± 3.65, P = .092). When stratified by lung function status, the difference remained significant for those with normal lung function (4.32 ± 5.32 vs. 2.78 ± 3.86, P = .003) and reduced lung function (4.19 ± 4.93 vs. 2.11 ± 3.55, P ≤ 0.001). Multivariate logistic regression analysis revealed that chronic cough was associated with PHQ-9 score (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.014-1.27, P = .014), chronic obstructive pulmonary disease (OR, 4.87; 95% CI, 1.041-22.86, P = .044) and physician-diagnosed bronchial asthma (OR, 2.93; 95% CI, 1.162-7.435, P = .023). Conclusions: Depressive mood is significantly correlated with chronic cough in females. |HEO Et al.How to cite this article: Heo IR, Kim J-Y, Go S-I, et al. Chronic cough is associated with depressive mood in women regardless of smoking status and lung function.

The interrelationship of chronic cough and depression: a prospective population-based study

“…Our findings corroborate previous studies indicating that persons with chronic cough have a substantially higher burden of depressive symptoms [9,13], independent of commonly associated risk factors and comorbidities such as smoking and asthma [5,15,16]. In our study, chronic cough was also associated with higher burden of depressive symptoms after adjusting for preexisting respiratory diseases including chronic rhinosinusitis, asthma, COPD, and lung cancer, albeit with smaller effect sizes.…”

“…This is line with previous research. For example, Heo et al found that, compared to persons without chronic cough, patients with chronic cough had more severe depressed mood regardless of their smoking and lung function status [15].…”

“…Individuals with chronic cough frequently experience physical and psychosocial conditions including social isolation, physical exhaustion, sleep complaints, stress incontinence, cough syncope, and a lower quality of life [8][9][10][11][12][13]. Also, mental health complaints including depressive symptoms and major depressive disorder are common in people with chronic cough [5,9,[13][14][15]. Depression additionally contributes to the overall clinical burden of the diseases commonly underlying chronic cough [13,16].…”

“…So far, most studies on chronic cough and depression involved patients referred to specialist cough clinics, whose clinical profiles may differ from that of the general population [9,13,16]. Furthermore, the evidence on the burden of depression in chronic cough in populationbased samples has come mainly from cross-sectional studies and provided little insight into the temporal association between chronic cough and depression [5,15]. We therefore conducted a population-based observational cohort study in middle-aged and older adults to investigate the association between chronic cough and prospectively assessed depressive symptoms and disorders over time.…”