The association of anxiety and depression with mortality in a COPD cohort. The HUNT study, Norway

Vikjord, Sigrid Anna Aalberg; Brumpton, Ben; Mai, Xiao-Mei; Vanfleteren, Lowie E.G.W.; Langhammer, Arnulf

doi:10.1016/j.rmed.2020.106089

Cited by 30 publications

(13 citation statements)

References 44 publications

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“…Multi-variable analysis adjusting for age, sex, NYHA class, cardiac risk factors and laboratory parameters found that depression together with treatment with benzodiazepines was most predictive of increased mortality. These findings are parallel to those seen in other medical conditions, as anxiety has been associated with increased mortality in cancer patients [15] and in patients with COPD [16], and population studies have found that there is an average of 7.5 excess years of life lost in men with anxiety and 6.3 excess years of life lost in women with anxiety [17]. Anxiety and depression frequently co-exist [18]; patients with major depression report high rates of co-occurring anxiety disorders, and anxiety disorders are more likely to precede the onset of depression rather than the reverse.…”

Section: Discussionsupporting

confidence: 70%

Treatment of Heart Failure Patients with Anxiolytics Is Associated with Adverse Outcomes, with and without Depression

Zwas

Keren

Amir

et al. 2020

JCM

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Background: Few studies have evaluated the effect of pharmacologic treatment of anxiety on outcomes in heart failure (HF) patients. This study examined the impact of treatment with anxiolytics on clinical outcomes in a real-world sample of HF patients with and without depression. Methods: Patients diagnosed with HF were retrieved from a large HMO database. Patients prescribed anxiolytic medication and patients diagnosed with depression and/or prescribed anti-depressant medication were followed for cardiac-related hospitalizations and death. Results: The study cohort included 6293 HF patients. Treatment with anxiolytics was associated with decreased one-year survival compared to untreated individuals, with a greater reduction in survival seen in patients diagnosed with depression and/or treated with anti-depressants. Multi-variable analysis adjusting for age, sex, NYHA class, cardiac risk factors and laboratory parameters found that treatment with anxiolytics remained a predictor of mortality even when adjusting for depression. Depression combined with anxiolytic treatment was predictive of increased mortality, and treatment with anxiolytics alone, depression alone and anxiolytic treatment together with depression were each associated with an increased hazard ratio for a composite outcome of death and hospitalization. Conclusions: In this real-world study of HF patients, both treatment with anxiolytics and depression were associated with increased mortality, and anxiolytic therapy remained a predictor of mortality when adjusting for depression. Treatment of anxiety together with depression was associated with the highest risk of mortality. Safe and effective treatment for anxiety and depression is warranted to alleviate the detrimental impact of these disorders on quality and of life and adverse events.

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Section: Discussionsupporting

confidence: 70%

Treatment of Heart Failure Patients with Anxiolytics Is Associated with Adverse Outcomes, with and without Depression

Zwas

Keren

Amir

et al. 2020

JCM

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“…4 Various authors have related anxiety and depression with an increased risk of mortality after hospital discharge. 13,14 In our study, we have found no relationship between anxiety and depression with mortality, but surprisingly, mortality at 18 months is lower in patients with depression. Previous studies found a slight protective effect of anxiety on hospital mortality 15 or higher anxiety in women than in men in COPD patients, but no differences in mortality at 3 years after adjusting by age and FEV1.…”

Section: Discussioncontrasting

confidence: 59%

“…Moreover, depression and anxiety interfere with other risk factors, such as tobacco use, and, in general, they impair patients' quality of lif. 3,11 However, the debate on the impact of anxiety and depression on the prognosis of COPD patients continues, as some authors report worse disease progression, [12][13][14] while other researchers have not observed any association between anxiety or depression and worse prognosis of acute exacerbations of COPD (AECOPD). 15,16 Also, though some studies have analyzed the relationship between depression and anxiety with COPD, both entities are underdiagnosed in these patients and therefore rarely treated properly.…”

Section: Introductionmentioning

confidence: 99%

Impact of Anxiety and Depression on The Prognosis of COPD Exacerbations

Martínez-Gestoso¹,

García-Sanz

Carreira

et al. 2022

Preprint

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Background: Frequent and highly prevalent as comorbidities in Chronic obstructive pulmonary disease (COPD) patients, both depression and anxiety seem to have an impact on COPD prognosis. However, they are underdiagnosed and rarely treated properly. Aim: to establish the prevalence of depression and anxiety in patients admitted for acute exacerbation of COPD (AECOPD) and determine their influence on COPD prognosis.Methods: Prospective observational study conducted from October 1, 2016 to October 1, 2018 at the following centers in Galicia, Spain: Salnés County Hospital, Arquitecto Marcide, and Clinic Hospital Complex of Santiago de Compostela. Patients admitted for AECOPD who agreed to participate and completed the anxiety and depression scale (HADS) were included in the study.Results: 288 patients (46.8%) were included, mean age was 73.7 years (SD 10.9), 84.7% were male. 67.7% patients were diagnosed with probable depression, and depression was established in 41.7%; anxiety was probable in 68.2% and established in 35.4%. 60.4% of all patients showed symptoms of both anxiety and depression. Multivariate analysis relates established depression with a higher risk of late readmission (OR 2.06, 95% CI 1.28; 3.31) and a lower risk of mortality at 18 months (OR 0.57, 95% CI 0.37;0.90) Conclusion: the prevalence of anxiety and depression in COPD patients is high. Depression seems to be an independent factor for AECOPD, so early detection and a multidisciplinary approach could improve the prognosis of both entities.The study was approved by the Ethical Committee of Galicia (code 2016/460).

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“…Mental illness, especially depression, was diagnosed significantly more frequently in women than in men and was also predictive for mortality exclusively in women. The association between mortality and depression may be linked to insufficient healthcare utilization and poorer treatment compliance 42 . On the other hand, it should be noted that depressive symptoms reflected in diagnostic scores can interfere with COPD symptoms and comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

Trudzinski

Jörres

Alter

et al. 2022

Sci Rep

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In patients with COPD, it has not been comprehensively assessed whether the predictive value of comorbidities for mortality differs between men and women. We therefore aimed to examine sex differences of COPD comorbidities in regard with prognosis by classifying comorbidities into a comorbidome related to extrapulmonary disorders and a pulmorbidome, referring to pulmonary disorders. The study population comprised 1044 women and 1531 men with the diagnosis of COPD from COSYCONET, among them 2175 of GOLD grades 1–4 and 400 at risk. Associations of comorbidities with mortality were studied using Cox regression analysis for men and women separately. During the follow-up (median 3.7 years) 59 women and 159 men died. In men, obesity, hypertension, coronary artery disease, liver cirrhosis, osteoporosis, kidney disease, anaemia and increased heart rate (HR) predict mortality, in women heart failure, hyperuricemia, mental disorders, kidney disease and increased HR (p < 0.05 each). Regarding the pulmorbidome, significant predictors in men were impairment in diffusion capacity and hyperinflation, in women asthma and hyperinflation. Similar results were obtained when repeating the analyses in GOLD 1–4 patients only. Gender differences should be considered in COPD risk assessment for a tailored approach towards the treatment of COPD.Clinical Trial Registration: ClinicalTrials.gov NCT01245933.

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The association of anxiety and depression with mortality in a COPD cohort. The HUNT study, Norway

Cited by 30 publications

References 44 publications

Treatment of Heart Failure Patients with Anxiolytics Is Associated with Adverse Outcomes, with and without Depression

Treatment of Heart Failure Patients with Anxiolytics Is Associated with Adverse Outcomes, with and without Depression

Impact of Anxiety and Depression on The Prognosis of COPD Exacerbations

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

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