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

Marta Fuentes-Alonso,Marta Lopez-Herranz,José J Zamorano-León,Ana López-De-Andrés,Rodrigo Jiménez-García,Isabel Jimenez-Trujillo,Clara Maestre-Miquel,Javier De Miguel-Diez,Zichen Ji

doi:10.3390/jcm10132786

Abstract

(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.

Highlights

Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition associated with high morbidity and mortality throughout the world [1]
As can be seen for the three variables analyzed, the prevalence among COPD cases is significantly higher in all the categories of most socio-demographic variables compared with non-COPD controls
It is remarkable that the highest prevalence was found among those COPD cases with lower educational and social class levels for the three mental health variables

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition associated with high morbidity and mortality throughout the world [1]. COPD patients present more frequently than the general population other concomitant comorbidities These include cardiovascular disease (ischemic heart disease, heart failure, or stroke), high blood pressure, diabetes mellitus, kidney failure, osteoporosis, skeletal muscle dysfunction, lung cancer, and psychiatric diseases (depression and anxiety). These concomitant chronic diseases must be actively sought, since they interact with each other, making their diagnosis and treatment difficult, and worsen the prognosis [5]. They must be treated early, as they independently increase hospitalizations and mortality in COPD patients [6]

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Discussion

Conclusion