Prevalence and Determinants of Mental Health among COPD Patients in a Population-Based Sample in Spain

Abstract

(1) Background: To assess the prevalence of mental disorders (depression and anxiety), psychological distress, and psychiatric medications consumption among persons suffering from COPD; to compare this prevalence with non-COPD controls and to identify which variables are associated with worse mental health. (2) Methods: This is an epidemiological case-control study. The data were obtained from the Spanish National Health Survey 2017. Subjects were classified as COPD if they reported suffering from COPD and the diagnosis of this condition had been confirmed by a physician. For each case, we selected a non-COPD control matched by sex, age, and province of residence. Conditional logistic regression was used for multivariable analysis. (3) Results: The prevalence of mental disorders (33.9% vs. 17.1%; p < 0.001), psychological distress (35.4% vs. 18.2%; p < 0.001), and psychiatric medications consumption (34.1% vs. 21.9%; p < 0.001) was higher among COPD cases compared with non-COPD controls. After controlling for possible confounding variables, such as comorbid conditions and lifestyles, using multivariable regression, the probability of reporting mental disorders (OR 1.41; 95% CI 1.10–1.82).), psychological distress (OR 1.48; 95% CI 1.12–1.91), and psychiatric medications consumption (OR 1.38 95% CI 1.11–1.71) remained associated with COPD. Among COPD cases, being a woman, poor self-perceived health, more use of health services, and active smoking increased the probability of suffering from mental disorders, psychological distress, and psychiatric medication use. Stroke and chronic pain were the comorbidities more strongly associated with these mental health variables. (4) Conclusions: COPD patients have worse mental health and higher psychological distress and consume more psychiatric medications than non-COPD matched controls. Variables associated with poorer mental health included being a woman, poor self-perceived health, use of health services, and active smoking.

The relationship between mental health continuum and care dependency in individuals with chronic obstructive pulmonary disease: A cross‐sectional study

“…When the effect of smoking habit on mental health levels was examined, unlike our result, in the study of Fuentes-Alonso et al (2021), active smoking was associated with high mental distress. However, the low mental health level of all individuals in our study may not have made a difference in smoking habits.…”

“…The difference may be due to the fact that the studies were conducted in different societies and the majority of our sample group consisted of male individuals. When other socio‐demographic factors were analysed, it was shown that living alone, low education and income level were associated with negative mental health in individuals with COPD in line with the literature (Fuentes‐Alonso et al, 2021; Mewes et al, 2016). When the employment status of the patients was examined, it was found that the patients who did not work had better mental health.…”

“…Considering that this result may be due to the difference in COPD severity between genders, however, there was no difference between genders in terms of COPD severity in this study. Other studies have shown that the female gender is associated with low quality of life and low psychological well‐being (Fuentes‐Alonso et al, 2021; Mewes et al, 2016). The difference may be due to the fact that the studies were conducted in different societies and the majority of our sample group consisted of male individuals.…”

National Trends in Prevalence of Depression in Men and Women with Chronic Obstructive Pulmonary Disease Hospitalized in Spain, 2016–2020

“…Even so, it is still more than three times higher in women than in men. Previous studies have demonstrated that depression, as well as other psychological disorders including anxiety and irritability, are more prevalent in women [ 17 , 18 , 19 , 20 ]. There are several sex-specific factors that could explain these results.…”

Nonpharmacological management of psychological distress in people with COPD

“…According to the biopsychosocial model, depression and anxiety may affect disease severity via mechanisms associated with poor treatment adherence and self-care. In addition, several factors such as smoking behaviour [ 68 – 70 ], physical activity levels [ 71 , 72 ], brain processes [ 62 , 73 , 74 ], sleeping patterns [ 75 , 76 ], inflammatory processes [ 15 , 77 ] and activation of cell-mediated immunity [ 78 ], fatigue [ 79 ] and genetic risk factors [ 80 , 81 ], are most likely involved as contributors or moderators, requiring future systematic studies. Moreover, biological stress systems in the brain ( e.g.…”