TY - JOUR
T1 - Association Among Chronic Obstructive Pulmonary Disease Severity, Exacerbation Risk, and Anxiety and Depression Symptoms in the SPIROMICS Cohort
AU - Weiss, Jacob R.
AU - Serdenes, Ryan
AU - Madtha, Uchechukwu
AU - Zhao, Huaqing
AU - Kim, Victor
AU - Lopez-Pastrana, Jahaira
AU - Eakin, Michelle N.
AU - O'Toole, Jacqueline
AU - Cooper, Christopher B.
AU - Woodruff, Prescott
AU - Kanner, Richard E.
AU - Krishnan, Jerry A.
AU - Iyer, Anand S.
AU - Couper, David
AU - Morrison, Mary F.
N1 - Funding Information:
Disclosure: In the past 3 years, Victor Kim, MD, reports receiving personal fees from Gala Therapeutics and the American Board of Internal Medicine, outside of the submitted work. Mary F. Morrison, MD, MS, is a consultant to Creative Biopeptides, unrelated to the submitted work. Anand S. Iyer, MD, MSPH, is supported by a K76 (K76 AG064327) from the National Institute on Aging of the National Institutes of Health. Jerry A. Krishnan, MD, PhD, reports research funding from National Institutes of Health (NIH), Patient-Centered Outcomes Research Institute, and American Lung Association; consulting on COVID-19 therapeutics by GlaxoSmithKline; and serving as a member of the Board of Directors for the Respiratory Health Association (unpaid, not-for-profit organization). All other authors have no competing interests or relationships to declare.
Funding Information:
Disclosure: In the past 3 years, Victor Kim, MD, reports receiving personal fees from Gala Therapeutics and the American Board of Internal Medicine, outside of the submitted work. Mary F. Morrison, MD, MS, is a consultant to Creative Biopeptides, unrelated to the submitted work. Anand S. Iyer, MD, MSPH, is supported by a K76 ( K76 AG064327 ) from the National Institute on Aging of the National Institutes of Health . Jerry A. Krishnan, MD, PhD, reports research funding from National Institutes of Health (NIH), Patient-Centered Outcomes Research Institute, and American Lung Association ; consulting on COVID-19 therapeutics by GlaxoSmithKline; and serving as a member of the Board of Directors for the Respiratory Health Association (unpaid, not-for-profit organization). All other authors have no competing interests or relationships to declare.
Publisher Copyright:
© 2022 The Authors
PY - 2023/1/1
Y1 - 2023/1/1
N2 - 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.
AB - 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.
KW - Global Initiative for Obstructive Lung Disease groups
KW - Subpopulations and Intermediate Outcome Measures in COPD Study
KW - anxiety
KW - chronic obstructive pulmonary disease
KW - depression
KW - hospital anxiety and depression scale
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U2 - 10.1016/j.jaclp.2022.07.008
DO - 10.1016/j.jaclp.2022.07.008
M3 - Article
C2 - 35948252
AN - SCOPUS:85138513927
SN - 2667-2979
VL - 64
SP - 45
EP - 57
JO - Journal of the Academy of Consultation-Liaison Psychiatry
JF - Journal of the Academy of Consultation-Liaison Psychiatry
IS - 1
ER -