Association Among Chronic Obstructive Pulmonary Disease Severity, Exacerbation Risk, and Anxiety and Depression Symptoms in the SPIROMICS Cohort
Year: 2022
Type: article
Abstract: BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common, progressive lung disease that often manifests with psychiatric symptoms. Despite this, patients with COPD are not routinely screened for anxiety and depression, which substantially contribute to COPD-related morbidity. OBJECTIVE: To determine the relationship among COPD symptom severity, exacerbation risk, and clinically significant anxiety and depression symptoms in ever smokers with COPD. METHODS: We used baseline data from the Subpopulations and Intermediate Outcome Measures In COPD Study (SPIROMICS) cohort to examine ever smokers with COPD across Global Initiative for Obstructive Lung Disease (GOLD) disease severity groups. Multivariable logistic regression models were used to calculate odds ratios for clinically significant anxiety and depression for each GOLD group, which was compared to the control group of ever smokers without COPD. Odds ratios were adjusted for subject demographics, medical comorbidities, and substance use covariates, and comparisons were completed using 2-tailed tests. RESULTS: Of the 2664 subjects studied, 784 (29.4%) had clinically significant anxiety, and 497 (18.7%) had clinically significant depression. In the multivariable analysis, high pulmonary symptom groups, groups B and D, had increased adjusted odds of clinically significant anxiety (group B: adjusted odds ratios [AOR] 1.28, P = 0.03; group D: AOR 1.95, P < 0.0001) and depression (group B: AOR 2.09, P < 0.0001; group D: AOR 3.04, P < 0.0001). GOLD group D, the group with high pulmonary symptoms and high COPD exacerbation risk, had the greatest risk of both anxiety and depression among the GOLD groups. CONCLUSIONS: High COPD symptom severity, even in the absence of elevated COPD exacerbation risk, is associated with clinically significant anxiety and depression. Our separate analyses of anxiety and depression symptoms in a large, multisite, national cohort are unique within the literature and have important treatment implications for COPD patients. Our findings also highlight the utility of screening patients with high COPD symptom severity for anxiety and depression.
Institutions: Temple University Hospital, Temple University Health System, Hospital of the University of Pennsylvania, University of Pennsylvania, Thomas Jefferson University Hospital, Johns Hopkins University, Johns Hopkins Medicine, University of California, Los Angeles, University of California, San Francisco, University of Utah, University of Illinois Chicago, University of Alabama at Birmingham, UAB Medicine, University of North Carolina at Chapel Hill
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,000
Funders: American Lung Association, AstraZeneca, GlaxoSmithKline, Sanofi, Patient-Centered Outcomes Research Institute, Ikaria, Chiesi Farmaceutici, Respiratory Health Association, COPD Foundation, Novartis Pharmaceuticals Corporation, Sunovion, Regeneron Pharmaceuticals, Mylan, Forest Research Institute, Grifols, National Institutes of Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, National Institute on Aging, National Heart, Lung, and Blood Institute
Awards: G1488133927, G1672953414, G2099663897, G2126848096, G2212190077, G2847413391, G3027037974, G3868091120, G3999916299, G4039356828, G409135471, G4578545918, G4586241626, G4671684786, G4749522346, Aging Well with COPD through Geriatrics-Palliative Care, G4940690932, G4975107759, G5195001291, G5434367891, G5510456481, G5566143793, G6107646161, G6112557991, G67127270, G7206313631, G87279447, G8837091488, G8957911378, G9000169132, G9000184499
OpenAlex ID: W4291021187