@article{c3cae3023a0b4ebcb2afc2b86c1ab499,
title = "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",
abstract = "Objectives: 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. Methods: 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. Key results: 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). Conclusions: 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. Primary funding source National Institutes of Health and The COPD Foundation.",
keywords = "Access to care, Antianxiety agents, Antidepressive agents, Anxiety, Chronic obstructive pulmonary disease, Clinical epidemiology, Depression, Mental health, Population health, Pulmonary diseases, Smoking",
author = "{For the COPDGene Investigators} and Iyer, {Anand S.} and Holm, {Kristen E.} and Bhatt, {Surya P.} and Victor Kim and Kinney, {Gregory L.} and Wamboldt, {Frederick S.} and Jacobs, {Michael R.} and Regan, {Elizabeth A.} and Armstrong, {Hilary F.} and Lowe, {Katherine E.} and Martinez, {Carlos H.} and Dransfield, {Mark T.} and Foreman, {Marilyn G.} and Gen Shinozaki and Hanania, {Nicola A.} and Wise, {Robert A.} and Make, {Barry J.} and Hoth, {Karin F.}",
note = "Funding Information: All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf . The COPDGene study is also supported by the COPD Foundation through contributions made to an Industry Advisory Board comprised of AstraZeneca, Boehringer-Ingelheim, Novartis, Pfizer, GlaxoSmithKline, Siemens and SunovionThe COPDGene study is supported by NHLBI U01 HL089897 and U01 HL089856 . The COPDGene study ( NCT00608764 ) is also supported by the COPD Foundation through contributions made to an Industry Advisory Committee comprised of AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Novartis, and Sunovion. ASI acknowledges support in part by a T32 training grant (T32HS013852) and an institutional UAB K12 in Patient Centered Outcomes Research (K12HS023009) from the Agency for Healthcare Research and Quality. KFH acknowledges grant support from the NHLBI (K23HL095658). VK has received grant support from the NHLBI, has been on advisory boards for CSA Medical, Concert Pharmaceuticals, AstraZeneca, and Gala Therapeutics, has been a peer reviewer for MedScape, and has received monetary stipends from the American Board of Internal Medicine for serving on the Critical Care Exam Board. MTD acknowledges grants from NIH and the Department of Defense, consulting fees from AstraZeneca, Boerhinger Ingelheim, Genentech, GlaxoSmithKline, and PneumRx/BTG and contracted clinical trial funding from AstraZeneca, Boerhinger Ingelheim, GlaxoSmithKline, Yungjin, PneumRx/BTG, Pulmonx, Novartis, and Boston Scientific. SPB acknowledges grant support from the NIH (K23HL133438), and his institution receives research funding from ProterixBio Inc. CHM would like to acknowledge NIH grant support from the NHLBI (K23HL128936–01 and 3R01HL122438-02S1). NAH has received honoraria for serving as an advisor or consultant for Astra Zeneca, GSK, Boehringer Ingelheim, Sanofi/Regeneron and Novartis. His institution has received research grant support on his behalf from GSK, Boehringer Ingelheim, Astra Zeneca and Genentech. BJM reports funding from the NHLBI for the COPDGene study; grants and personal fees from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, and Sunovian; personal fees for DSMB from Spiration and Baxalta; CME personal fees from Consensus Medical Education, Integrity Medical Education, WebMD, National Jewish Health, American College of Chest Physicians, Projects in Knowledge, Hybrid Communications, SPIRE Learning, Peer Review Institute, and Medscape; personal fees and other from Mt. Sinai Medical Center; royalties from Up-To-Date; personal fees from Novartis; personal fees from CSL Bering; other from Cleveland Clinic; grants from Pearl; and personal fees from Verona, outside the submitted work. KEH, GLK, FSW, MRJ, EAR, HFA, KEL, MGF, GS, and RAW have no conflicts to report. Funding Information: The COPDGene Study is supported by the National Institutes of Health and the COPD Foundation, and neither contributed to the design or conduct of this study. ",
year = "2019",
month = mar,
doi = "10.1016/j.jpsychores.2019.01.002",
language = "English (US)",
volume = "118",
pages = "18--26",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "Elsevier Inc.",
}