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Psychiatric disorders are more common in female than male patients with COPD
ARTICLE IN PRESS R E S P I R AT O RY M E D I C I N E : C O P D U P D AT E
4 (2008) 35– 38
LITERATURE REVIEW: NURSING CARE Psychiatric disorders are more common in female than male patients with COPD
This cross-sectional study of women and men with stable COPD examined the prevalence of mood and anxiety disorders, levels of psychological distress, and quality of life, using interviews, questionnaires and spirometry.
Abstract of Original Article Background: Psychiatric disorders are highly prevalent in patients with COPD. In general, psychiatric disorders are more common in women than in men. The extent to which women with COPD suffer from greater psychiatric and psychological morbidity is not known. The present cross-sectional study evaluated the prevalence of mood and anxiety disorders, levels of psychological distress, and quality of life in 62 women and 54 men with documented, stable COPD. Methods: All patients (n = 116) underwent a sociodemographic and medical history interview, followed by a structured psychiatric interview and standard spirometry. Patients also completed a battery of questionnaires measuring psychological distress and quality of life. Results: The overall prevalence of psychiatric disorders was 49%. Significantly more women than men met the diagnostic criteria for
anxiety disorders (56% vs 35%), and a trend for greater levels of major depression in women was found (18% vs 7%). Women had significantly higher anxiety sensitivity and depressive symptoms compared to men but did not report more limitations in psychological functioning. Women also reported being less confident in their ability to control respiratory symptoms, and more daily physical limitations compared to men, despite having comparable COPD severity, dyspnea scores, and exacerbation rates. Conclusions: Results indicate that psychiatric disorders are at least three times higher in COPD patients compared to the general population, and nearly two times higher in women than in men. Women also have greater psychological distress, worse perceived control of symptoms, and greater functional impairment. Greater efforts should be made to identify and treat psychiatric disorders in COPD patients, particularly in women. & 2007 American College of Chest Physicians.
Commentary by Kathy Pye Aintree Chest Centre, University Hospital Aintree, Liverpool, UK Anxiety and depression are a major feature in patients with COPD, and occur at a higher rate than in the general population. This study examined the prevalence of psychological disorders in patients with COPD and studied the differences in prevalence between men and women. Recruited subjects had all been hospitalised with an acute exacerbation in the previous two years but were stable in the four weeks prior to inclusion in the study. Assessment was by means of a structured psychiatric interview and health related and psychological questionnaires. Disease severity was measured using the BODE index. The incidence of psychiatric disorders in the whole population was high, with almost half of subjects classified as having at least one disorder. There were significantly higher rates of psychiatric disorders in women compared to men independent of age or disease severity. Specifically phobia and panic were significantly higher in women. Although there is no real evidence of the cause of these gender differences, the authors hypothesised that COPD may impact women’s mental health and wellbeing more than men’s. Another reported possibility could be that in this group more men than women smoked and drank alcohol, and this in itself is said to be a coping strategy. So men may suffer the same level of psychological disturbance as women, but their reported levels of distress were minimised by alcohol and tobacco use. This study emphasises the high incidence of psychiatric disorders in patients with COPD, especially in women. Psychiatric disorders are largely under-diagnosed and under-treated in such patients, the consequence of which is reduced function and quality of life. These data highlight the need for further study to understand the gender differences and to enable us to assess the impact of these disorders on morbidity and mortality. This study was also featured in the News section of issue 3(4).
Original article reference: Laurin C, Lavoie KL, Bacon SL, Duphius G, Lacoste G, Cartier A, Labrecque M. Sex differences in the prevalence of psychiatric disorders and psychological distress in patients with COPD.Chest 2007;132:148–55.
10.1016/j.rmedu.2007.11.011 1745-0454/$ - see front matter
4 (2008) 35– 38
LITERATURE REVIEW: NURSING CARE Psychiatric disorders are more common in female than male patients with COPD
This cross-sectional study of women and men with stable COPD examined the prevalence of mood and anxiety disorders, levels of psychological distress, and quality of life, using interviews, questionnaires and spirometry.
Abstract of Original Article Background: Psychiatric disorders are highly prevalent in patients with COPD. In general, psychiatric disorders are more common in women than in men. The extent to which women with COPD suffer from greater psychiatric and psychological morbidity is not known. The present cross-sectional study evaluated the prevalence of mood and anxiety disorders, levels of psychological distress, and quality of life in 62 women and 54 men with documented, stable COPD. Methods: All patients (n = 116) underwent a sociodemographic and medical history interview, followed by a structured psychiatric interview and standard spirometry. Patients also completed a battery of questionnaires measuring psychological distress and quality of life. Results: The overall prevalence of psychiatric disorders was 49%. Significantly more women than men met the diagnostic criteria for
anxiety disorders (56% vs 35%), and a trend for greater levels of major depression in women was found (18% vs 7%). Women had significantly higher anxiety sensitivity and depressive symptoms compared to men but did not report more limitations in psychological functioning. Women also reported being less confident in their ability to control respiratory symptoms, and more daily physical limitations compared to men, despite having comparable COPD severity, dyspnea scores, and exacerbation rates. Conclusions: Results indicate that psychiatric disorders are at least three times higher in COPD patients compared to the general population, and nearly two times higher in women than in men. Women also have greater psychological distress, worse perceived control of symptoms, and greater functional impairment. Greater efforts should be made to identify and treat psychiatric disorders in COPD patients, particularly in women. & 2007 American College of Chest Physicians.
Commentary by Kathy Pye Aintree Chest Centre, University Hospital Aintree, Liverpool, UK Anxiety and depression are a major feature in patients with COPD, and occur at a higher rate than in the general population. This study examined the prevalence of psychological disorders in patients with COPD and studied the differences in prevalence between men and women. Recruited subjects had all been hospitalised with an acute exacerbation in the previous two years but were stable in the four weeks prior to inclusion in the study. Assessment was by means of a structured psychiatric interview and health related and psychological questionnaires. Disease severity was measured using the BODE index. The incidence of psychiatric disorders in the whole population was high, with almost half of subjects classified as having at least one disorder. There were significantly higher rates of psychiatric disorders in women compared to men independent of age or disease severity. Specifically phobia and panic were significantly higher in women. Although there is no real evidence of the cause of these gender differences, the authors hypothesised that COPD may impact women’s mental health and wellbeing more than men’s. Another reported possibility could be that in this group more men than women smoked and drank alcohol, and this in itself is said to be a coping strategy. So men may suffer the same level of psychological disturbance as women, but their reported levels of distress were minimised by alcohol and tobacco use. This study emphasises the high incidence of psychiatric disorders in patients with COPD, especially in women. Psychiatric disorders are largely under-diagnosed and under-treated in such patients, the consequence of which is reduced function and quality of life. These data highlight the need for further study to understand the gender differences and to enable us to assess the impact of these disorders on morbidity and mortality. This study was also featured in the News section of issue 3(4).
Original article reference: Laurin C, Lavoie KL, Bacon SL, Duphius G, Lacoste G, Cartier A, Labrecque M. Sex differences in the prevalence of psychiatric disorders and psychological distress in patients with COPD.Chest 2007;132:148–55.
10.1016/j.rmedu.2007.11.011 1745-0454/$ - see front matter