Journal article
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
Journal of psychosomatic research, Vol.118, pp.18-26
03/2019
DOI: 10.1016/j.jpsychores.2019.01.002
PMCID: PMC6383809
PMID: 30782350
Abstract
To compare the frequency of anxiety/depressive symptoms and use of anxiolytic-hypnotics/antidepressants in smokers with and without COPD and to identify characteristics associated with having unmedicated symptoms.
Cross-sectional analysis of ambulatory, current/former smokers ≥10 pack years enrolled in the COPDGene study. We measured anxiety/depressive symptoms using the Hospital Anxiety and Depression Scale (subscales ≥8), recorded anxiolytic-hypnotic/antidepressant use, and defined unmedicated symptoms as elevated anxiety/depressive symptoms and not on medications. Regression analysis identified characteristics associated with having unmedicated symptoms.
Of 5331 current/former smokers (45% with and 55% without COPD), 1332 (25.0%) had anxiety/depressive symptoms. Anxiety symptoms were similar in frequency in smokers with and without COPD (19.7% overall), while depressive symptoms were most frequent in severe-very severe COPD at 20.7% (13.1% overall). In the entire cohort, 1135 (21.2%) were on medications. Anxiolytic-hypnotic use was highest in severe-very severe COPD (range 7.6%–12.0%), while antidepressant use showed no significant variation in smokers with and without COPD (range 14.7%–17.1%). Overall, 881 (66% of those with symptoms) had unmedicated symptoms, which was associated with African American race (adjusted OR 2.95, 95% CI 2.25–3.87), male gender (adjusted OR 1.93, 95% CI 1.57–2.36), no health insurance (adjusted OR 2.38, 95% CI 1.30–4.35), severe-very severe COPD (adjusted OR 1.48, 95% CI 1.04–2.11), and higher respiratory symptoms/exacerbation history (adjusted OR 2.21, 95% CI 1.62–3.02).
Significant unmet mental health care needs exist in current and former smokers with and without COPD. One in five have unmedicated symptoms, identified by key demographic and clinical characteristics.
National Institutes of Health and The COPD Foundation.
•Significant unmet mental healthcare needs exist in current and former smokers.•Symptoms of anxiety/depression and use of anxiolytic-hypnotics/antidepressants vary across COPD severity stages.•One in five smokers have unmedicated anxiety/depressive symptoms.•Subgroups of smokers are at risk for unmedicated anxiety/depressive symptoms.•Characteristics identify smokers at highest risk for having unmedicated symptoms.
Details
- Title: Subtitle
- 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
- Creators
- Anand S Iyer - Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USAKristen E Holm - Department of Medicine, National Jewish Health, Denver, CO, USASurya P Bhatt - Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USAVictor Kim - Department of Thoracic Medicine and Surgery, Temple University School of Medicine Philadelphia, PA, USAGregory L Kinney - Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USAFrederick S Wamboldt - Department of Medicine, National Jewish Health, Denver, CO, USAMichael R Jacobs - Department of Thoracic Medicine and Surgery, Temple University School of Medicine Philadelphia, PA, USAElizabeth A Regan - Department of Medicine, National Jewish Health, Denver, CO, USAHilary F Armstrong - Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USAKatherine E Lowe - Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USACarlos H Martinez - Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USAMark T Dransfield - Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USAMarilyn G Foreman - Division of Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA, USAGen Shinozaki - Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USANicola A Hanania - Division of Pulmonary/Critical Care Medicine, Baylor College of Medicine, Houston, TX, USARobert A Wise - Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USABarry J Make - Department of Medicine, National Jewish Health, Denver, CO, USAKarin F Hoth - Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Journal of psychosomatic research, Vol.118, pp.18-26
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jpsychores.2019.01.002
- PMID
- 30782350
- PMCID
- PMC6383809
- ISSN
- 0022-3999
- eISSN
- 1879-1360
- Grant note
- National Institutes of Health (https://doi.org/10.13039/100000002)\r\nCOPD Foundation (https://doi.org/10.13039/100008184)
- Language
- English
- Date published
- 03/2019
- Academic Unit
- Psychiatry; Iowa Neuroscience Institute; Anesthesia; Neurosurgery
- Record Identifier
- 9984066389002771
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