Home > Associations between DSM-IV mental disorders and subsequent COPD diagnosis.

Rapsey, Charlene M and Lim, Carmen C W and Al-Hamzawi, Ali and Alonso, Jordi and Bruffaerts, Ronny and Caldas-de-Almeida, José Miguel and Florescu, Silvia and de Girolamo, Giovanni and Hu, Chiyi and Kessler, Ronald C and Kovess-Masfety, Viviane and Levinson, Daphna and Medina-Mora, María Elena and Murphy, Sam and Ono, Yutaka and Piazza, Maria and Posada-Villa, Jose and ten Have, Margreet and Wojtyniak, Bogdan and Scott, Kate M (2015) Associations between DSM-IV mental disorders and subsequent COPD diagnosis. Journal of Psychosomatic Research, 79, (5), pp. 333-339.

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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