Factors associated with new onset of depression and anxiety symptoms differ by sex in the COPDGene study

Kirsten Voorhies; Jess G. Fiedorowicz; Abebaw M. Yohannes; Gregory L. Kinney; Dawn L. DeMeo; Elizabeth A. Regan; James D. Crapo; Edwin K. Silverman; Christoph Lange; Karin F. Hoth; Sharon M. Lutz

doi:10.1016/j.jpsychores.2025.112345

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Factors associated with new onset of depression and anxiety symptoms differ by sex in the COPDGene study

Journal article

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Factors associated with new onset of depression and anxiety symptoms differ by sex in the COPDGene study

Kirsten Voorhies, Jess G. Fiedorowicz, Abebaw M. Yohannes, Gregory L. Kinney, Dawn L. DeMeo, Elizabeth A. Regan, James D. Crapo, Edwin K. Silverman, Christoph Lange, Karin F. Hoth, …

Journal of psychosomatic research, Vol.197, 112345

10/2025

DOI: 10.1016/j.jpsychores.2025.112345

PMCID: PMC12798645

PMID: 40840304

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Abstract

Examine clinical and demographic variables associated with new onset depression and anxiety symptoms and assess moderation by sex in COPDGene, a cohort study of current and former smokers at risk for or with chronic obstructive pulmonary disease (COPD). In the COPDGene study, 2653 adults had the hospital anxiety (HADS-A) and depression (HADS-D) scales available at phase 2 and 3, as well as clinical and demographic variables available at 2 and non-elevated HADS at phase 2. We defined new onset depression symptoms as HADS-D elevated at phase 3 (HADS-D ≥ 8) versus no new onset as HADS-D not elevated at either phase (HADS-D < 8). New onset anxiety symptoms were defined identically using HADS-A. We used logistic regression models among all participants and stratified by sex and assessed sex interactions for variables associated with the outcome for only one sex. Among males, COPD Assessment test (CAT) score was positively associated with new onset depression (β = 0.08, p = 1.9 × 10−5) and anxiety (β = 0.06, p = 1.4 × 10−3) symptoms. Among females, the modified Medical Research Council (mMRC) dyspnea was positively associated with new onset anxiety symptoms (β = 0.33, p = 1.4 × 10−3). We found sex by CAT score (β = −0.06, p = 0.02) and sex by mMRC dyspnea (β = 0.42, p = 5.1 × 10−3) interactions on new onset anxiety symptoms, and sex by CAT score interaction (β = −0.05, p = 0.04) on new onset depression symptoms. These findings highlight the importance of understanding factors that increase risk for depression and anxiety among smokers at risk for or with COPD and are moderated by sex. •Sex moderates psychological distress associations in smokers with/at risk for COPD.•CAT score associated with new onset depression and anxiety symptoms among males.•MMRC dyspnea associated with new onset anxiety symptoms among females.

Anxiety

Depression

Hospital anxiety and depression scale (HADS)

Sex

Details

Title: Subtitle: Factors associated with new onset of depression and anxiety symptoms differ by sex in the COPDGene study
Creators: Kirsten Voorhies - Harvard Pilgrim Health Care
Jess G. Fiedorowicz - University of Ottawa
Abebaw M. Yohannes - University of Alabama at Birmingham
Gregory L. Kinney - University of Colorado Anschutz Medical Campus
Dawn L. DeMeo - Brigham and Women's Hospital
Elizabeth A. Regan - National Jewish Health
James D. Crapo - National Jewish Health
Edwin K. Silverman - Brigham and Women's Hospital
Christoph Lange - Harvard University
Karin F. Hoth - University of Iowa
Sharon M. Lutz - Harvard Pilgrim Health Care
Resource Type: Journal article
Publication Details: Journal of psychosomatic research, Vol.197, 112345
DOI: 10.1016/j.jpsychores.2025.112345
PMID: 40840304
PMCID: PMC12798645
NLM abbreviation: J Psychosom Res
ISSN: 0022-3999
eISSN: 1879-1360
Publisher: Elsevier Inc
Grant note: COPDGene study: R01MH129337, K24HL171900 NHLBI: U01HL089897, U01HL089856 NIHCOPD Foundation: 75N92023D00011 Bayer PharmaceuticalsBoehringer-IngelheimGenentechGlaxoSmithKlinePfizerSunovion
This research was funded by the National Institute of Mental Health R01MH129337 (SML, KV, CL, KFH) . DLD is supported by K24HL171900. The COPDGene study (NCT00608764) is supported by grants from the NHLBI (U01HL089897 and U01HL089856) , by NIH contract 75N92023D00011, and by the COPD Foundation through contributions made to an Industry Advisory Committee that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion.r R01MH129337 (SML, KV, CL, KFH) . DLD is supported by K24HL171900. The COPDGene study (NCT00608764) is supported by grants from the NHLBI (U01HL089897 and U01HL089856) , by NIH contract 75N92023D00011, and by the COPD Foundation through contributions made to an Industry Advisory Committee that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion.
Language: English
Electronic publication date: 08/07/2025
Date published: 10/2025
Academic Unit: Psychiatry; Epidemiology; Iowa Neuroscience Institute
Record Identifier: 9984946698802771

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