People with chronic obstructive pulmonary disorder (COPD) and those who smoke are at an increased risk of developing depression, results of a population-based cohort study of more than 3 million patients show.
Using data from the Veterans Affairs Corporate Data Warehouse, Natalie B. Riblet, MD, MPH, and colleagues conducted the study on 3,284,496 patients who accessed VA health care during 2004-2014 and had a negative depression screen. About 95% of this population was male, 83.4% were white, and the average age was 61.3 years. Just under 40,000 people were patients with COPD, reported Dr. Riblet, of the Veterans Affairs Medical Center in White River Junction, Vt., and the Geisel School of Medicine at Dartmouth, Hanover, N.H. The study was published in General Hospital Psychiatry.
The investigators found that current, former, and never smokers were split fairly evenly at 32.1%, 32.4%, and 30.3% of the total study population, respectively. Of those with COPD, 53.6% were current smokers, 27% were former smokers, and 11.6% were never smokers.
The odds of developing depression in a year were 2.3%, 1.5%, and 1.4% in current, former, and never smokers without COPD, respectively; for those with COPD, the odds were 2.9%, 2.2%, and 2% for current, former, and never smokers, respectively. Overall, the odds ratio of patients with COPD developing depression, compared with those without COPD, was 1.57 (95% confidence interval, 1.54-1.61). Current smokers also were at an increased risk, compared with never smokers (OR, 1.83; 95% CI, 1.81-1.85), though the effect was somewhat mitigated after adjusting for confounders (OR, 1.56; 95% CI, 1.55-1.58).
as this may guide the development and implementation of new treatments for depression in the COPD population,” the investigators concluded. “If COPD-related depression is due, at least in part, to adverse physiological effects related to chronic hypoxia, these patients may require new or more tailored interventions.”
No disclosures or conflicts of interest were reported.
SOURCE: Riblet NB et al. Gen Hosp Psychiatry. 2020 May-Jun;64:72-9.