Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - A cross sectional analysis of the COPDGene cohort

Iyer, Anand S; Holm, Kristen E.; Bhatt, Surya P.; Kim, Victor; Kinney, Gregory L.; Wamboldt, Frederick S.; Jacobs, Michael; Regan, Elizabeth A.; Armstrong, Hilary F.; Lowe, Katherine; Martínez, Carlos H.; Dransfield, Mark T.; Foreman, Marilyn G.; Shinozaki, Gen; Hanania, Nicola A.; Wise, Robert A.; Make, Barry J.; Hoth, Karin F.

doi:10.1016/j.jpsychores.2019.01.002

Cited by 26 publications

(15 citation statements)

References 49 publications

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“…While the Global Initiative for Chronic Obstructive Lung Disease guidelines recommend actively screening for and managing psychological comorbidities in COPD 11,16,19 , reportedly less than one-third of people with COPD and mental illness receive adequate treatment for psychological issues 16,20 . Absence of a standardised approach to the assessment and treatment of mental health conditions in people with COPD may partly explain why anxiety and depressive disorders are under-treated 13,16,21 . However, the under-treatment of mental health disorders in people with COPD is most likely due to a series of complex interrelated factors, including patient, provider and health system barriers 16,22 .…”

Section: Introductionmentioning

confidence: 99%

The complexity of mental health care for people with COPD: a qualitative study of clinicians’ perspectives

Wang

Willis

Barson

et al. 2021

npj Prim. Care Respir. Med.

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Anxiety and depression are common mental health illnesses in people with chronic obstructive pulmonary disease (COPD). However, patients often decline formal mental health care with barriers identified at the patient, health provider and health system levels. Currently clinicians’ perspectives on this issue are not well understood. A qualitative study using semi-structured interviews was undertaken to explore clinician perceived barriers and facilitators to acceptance of psychological care amongst people with COPD. Twenty-four Australian respiratory health professionals participated. Interview transcripts were analysed thematically. An overarching theme of ‘complexity’ was identified, which was evident across five domains: (1) physical and mental health illnesses; (2) psychosocial circumstances; (3) community views and stigma; (4) educational needs and knowledge gaps; (5) navigating the health system. Targeted patient education around psychological interventions and integration of mental health clinicians within multidisciplinary outpatient respiratory services are needed to address the current challenges.

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Section: Introductionmentioning

confidence: 99%

The complexity of mental health care for people with COPD: a qualitative study of clinicians’ perspectives

Wang

Willis

Barson

et al. 2021

npj Prim. Care Respir. Med.

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“…The prevalence of psychiatric disorders, including anxiety and depression, in COPD patients is higher than in the general population [7]. In addition, these pathologies can go unnoticed since, in many cases, it is difficult to distinguish between anxiety and the dyspnoea typical of COPD, due to the fact that both entities frequently overlap [8].…”

Section: Introductionmentioning

confidence: 99%

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

Fuentes-Alonso

López-Herránz

López‐de‐Andrés

et al. 2021

JCM

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(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.

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“…The prevalence for AD usage in our HPN‐dependent cohort was 41.7% (70 of 168 patients). These values are higher than those noted in the general population (9%–13%) 26,27 and other chronic diseases such as type 2 diabetes (17%) 28 , heart failure (7%) 29 , chronic obstructive pulmonary disease (14.7%), 30 chronic kidney disease (18.2%), 31 and cancer survivors (14.1%) 32 but are similar to the prevalence of AD use previously observed in patients with inflammatory bowel disease (28%) 33–35 . It is noteworthy that 56% of 85 HPN‐dependent patients in another recent study from our center were found to display clinically significant levels of depression and anxiety 16 .…”

Section: Discussionmentioning

confidence: 66%

Factors affecting antidepressant use by patients requiring home parenteral nutrition

Cloutier

Deutsch

Miller

et al. 2021

J Parenter Enteral Nutr

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Background Home parenteral nutrition (HPN) is a life‐saving therapy for patients with chronic intestinal failure but can be associated with a degree of psychological distress. The factors associated with the need for antidepressants (ADs) in this cohort have not yet been described. Methods The study involved prospective data collection from patients attending an HPN clinic at a national intestinal failure referral center. Patients requiring HPN as a result of active malignancy were excluded. Patients were divided in 2 groups according to AD usage; demographic, anthropometric, socioeconomic characteristics, and intravenous supplementation (IVS) regimens were compared between groups. Results A total of 184 patients were recruited between July 2018 and April 2019, with an overall prevalence of AD use of 41.7% (70/168 patients). Daily mean IVS volume was significantly higher among patients taking AD (“AD” group; 2125.48 ± 991.8 ml/day, “no‐AD” group; 1828.54 ± 847.0 ml/day, P = .039), with the proportion of patients needing high‐volume IVS (≥3000 ml/day) being 3 times higher in the AD group (20.0%(14/70 patients) vs 6.1% (6/98 patients), P = .006). The average energy IVS infusion per day was similar between the groups. Conclusion This is the first study to demonstrate that AD use correlates with higher IVS volume rather than energy requirements in HPN patients, suggesting that high IVS volume requirements may be better associated with the patient's disease burden. Early and tailored mental health intervention may be beneficial in those with high IVS volume requirements.

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Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - A cross sectional analysis of the COPDGene cohort

Abstract: AUTHOR CONTRIBUTIONS ASI and KFH take full responsibility for the study as a whole including conception and design of the study, data analysis, and manuscript preparation. ASI, KFH, GLK, FSW, and MRJ contributed to coding of psychiatric medication data.

Cited by 26 publications

References 49 publications

The complexity of mental health care for people with COPD: a qualitative study of clinicians’ perspectives

The complexity of mental health care for people with COPD: a qualitative study of clinicians’ perspectives

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

Factors affecting antidepressant use by patients requiring home parenteral nutrition

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