Charlene M Rapsey1, Carmen C W Lim2, Ali Al-Hamzawi3, Jordi Alonso4, Ronny Bruffaerts5, J M Caldas-de-Almeida6, Silvia Florescu7, Giovanni de Girolamo8, Chiyi Hu9, Ronald C Kessler10, Viviane Kovess-Masfety11, Daphna Levinson12, María Elena Medina-Mora13, Sam Murphy14, Yutaka Ono15, Maria Piazza16, Jose Posada-Villa17, Margreet ten Have18, Bogdan Wojtyniak19, Kate M Scott2. 1. Department of Psychological Medicine, University of Otago, Dunedin, New Zealand. Electronic address: charlene.rapsey@otago.ac.nz. 2. Department of Psychological Medicine, University of Otago, Dunedin, New Zealand. 3. College of Medicine, Al-Qadisiya University, Diwania governorate, Iraq. 4. IMIM-Institut Hospital del Mar d'Investigacions Mèdiques) CIBER en Epidemiolgía y Salud Pública (CIBERESP) UPF-Pompeu Fabra University, Spain. 5. University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Belgium. 6. Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal. 7. National School of Public Health, Management and Professional Development, Bucharest, Romania; Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Institute of Hygiene, Poland. 8. IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy. 9. Shenzhen Insitute of Mental Health & Shenzhen Kanging Hospital, PRC - Shenzhen. 10. Department of Health Care Policy, Harvard Medical School, Boston, MA, United States. 11. Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France. 12. Ministry of Health Israel, Mental Health Services, Israel. 13. Nacional Institute of Psychiatry Ramon de la Fuente, Mexico. 14. School of Psychology, University of Ulster, Northern Ireland. 15. Center for Cognitive Behavior Therapy and Research, National Center for Neurology and Psychiatry, Japan. 16. Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institute of Health, Peru. 17. Colegio Mayor de Cundinamarca University, Colombia. 18. Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Netherlands. 19. Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Institute of Hygiene, Poland.
Abstract
OBJECTIVES: COPD and mental disorder comorbidity is commonly reported, although findings are limited by substantive weaknesses. Moreover, few studies investigate mental disorder as a risk for COPD onset. This research aims to investigate associations between current (12-month) DSM-IV mental disorders and COPD, associations between temporally prior mental disorders and subsequent COPD diagnosis, and cumulative effect of multiple mental disorders. METHODS: Data were collected using population surveys of 19 countries (n=52,095). COPD diagnosis was assessed by self-report of physician's diagnosis. The World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) was used to retrospectively assess lifetime prevalence and age at onset of 16 DSM-IV disorders. Adjusting for age, gender, smoking, education, and country, survival analysis estimated associations between first onset of mental disorder and subsequent COPD diagnosis. RESULTS: COPD and several mental disorders were concurrently associated across the 12-month period (ORs 1.5-3.8). When examining associations between temporally prior disorders and COPD, all but two mental disorders were associated with COPD diagnosis (ORs 1.7-3.5). After comorbidity adjustment, depression, generalized anxiety disorder, and alcohol abuse were significantly associated with COPD (ORs 1.6-1.8). There was a substantive cumulative risk of COPD diagnosis following multiple mental disorders experienced over the lifetime. CONCLUSIONS: Mental disorder prevalence is higher in those with COPD than those without COPD. Over time, mental disorders are associated with subsequent diagnosis of COPD; further, the risk is cumulative for multiple diagnoses. Attention should be given to the role of mental disorders in the pathogenesis of COPD using prospective study designs.
OBJECTIVES:COPD and mental disorder comorbidity is commonly reported, although findings are limited by substantive weaknesses. Moreover, few studies investigate mental disorder as a risk for COPD onset. This research aims to investigate associations between current (12-month) DSM-IV mental disorders and COPD, associations between temporally prior mental disorders and subsequent COPD diagnosis, and cumulative effect of multiple mental disorders. METHODS: Data were collected using population surveys of 19 countries (n=52,095). COPD diagnosis was assessed by self-report of physician's diagnosis. The World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) was used to retrospectively assess lifetime prevalence and age at onset of 16 DSM-IV disorders. Adjusting for age, gender, smoking, education, and country, survival analysis estimated associations between first onset of mental disorder and subsequent COPD diagnosis. RESULTS:COPD and several mental disorders were concurrently associated across the 12-month period (ORs 1.5-3.8). When examining associations between temporally prior disorders and COPD, all but two mental disorders were associated with COPD diagnosis (ORs 1.7-3.5). After comorbidity adjustment, depression, generalized anxiety disorder, and alcohol abuse were significantly associated with COPD (ORs 1.6-1.8). There was a substantive cumulative risk of COPD diagnosis following multiple mental disorders experienced over the lifetime. CONCLUSIONS:Mental disorder prevalence is higher in those with COPD than those without COPD. Over time, mental disorders are associated with subsequent diagnosis of COPD; further, the risk is cumulative for multiple diagnoses. Attention should be given to the role of mental disorders in the pathogenesis of COPD using prospective study designs.
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