Research has documented a high prevalence of psychiatric disorders in patients with chronic obstructive pulmonary disease (COPD). In general, psychiatric disorders are more common in women than in men. However, few studies have evaluated sex differences in the prevalence of psychiatric disorders in COPD patients. The present study evaluated the prevalence of mood and anxiety disorders in 62 women and 54 men with documented, stable COPD.
Patients (n=116) underwent a sociodemographic and medical history interview, followed by a structured psychiatric interview (ADIS-IV). All patients underwent spirometry and completed a battery of questionnaires measuring psychological distress and quality of life.
A total of 57% of women vs. 35% of men met criteria for one or more anxiety disorder (Chi-Square=5.70, p<.01), and 31% of women vs. 14% of men met criteria for one or more mood disorder (Chi-Square =4.03, p<.05). The most common anxiety disorder among patients was panic disorder, affecting 27% of women and 11% of men (Chi-Square =4.83, p<.05). The most common mood disorder was major depression, affecting 18% of women and 6% of men (Chi-Square =6.70, p<.05). Women had significantly higher anxiety sensitivity and depression scores compared to men (p’s <.01). Women also reported being less confident in their ability to control respiratory symptoms compared to men (p<.05) and perceiving themselves as more limited in their activities as a result of their disease (p<.01), despite having comparable dyspnea scores (p=.08).There were no differences in exacerbation rates (last year) or forced expiratory volume in 1 second (FEV1, % predicted) between women and men.
Compared to prevalence rates in the general population (1-13%), results indicate that psychiatric disorders are at least three times higher in COPD patients, and that rates are nearly three times as high in women than in men. Women also show greater psychological distress, worse perceived control of symptoms and worse disease-related quality of life.
Greater efforts should be made to identify and treat psychiatric disorders in COPD patients, particularly in women.
Catherine Laurin, None.