Major affective disorders in chronic obstructive pulmonary disease compared with other chronic respiratory diseases

Figures & data

Table 1 Demographic data and major affective disorders from a total of 571 subjects

Characteristics	Respiratory disease		P-value	Risk assessment
	Yes (n=343)	No (n=228)
Age (years)	54.9±12.1	52.1±9.5	0.002
Age >60 years	216 (63)	45 (19.7)	0.005
Male sex	127 (37.0)	90 (39.5)	0.555
BMI (kg/m^2)	23.7±5.1	24.9±3.7	0.002
Percentage of predicted FEV	75.8±22.2	87.4±12.4	<0.001
Ratio of FEV1/FVC (%)	74.3±14.5	83.4±4.5	<0.001
At least one major mood disorder	132 (38.5)	90 (19.3)	<0.001	Relative risk =2.6 (95% CI [1.8–3.9, P<0.001])
				Adjusted odds ratio =2.7 (95% CI [1.8–3.9, P<0.001])
Generalized anxiety	61 (17.8)	11 (4.8)	0.002	Relative risk =4.3 (95% CI [2.2–8.3, P<0.001])
				Adjusted odds ratio =4.3 (95% CI [2.2–8.5, P=0.005])
Major depressive disorder	37 (10.8)	8 (3.5)	<0.001	Relative risk =3.3 (95% CI [1.5–7.3, P=0.002])
				Adjusted odds ratio =3.1 (95% CI [1.4–6.8, P<0.001])
Panic disorder	23 (6.7)	6 (2.6)	0.030	Relative risk =2.7 (95% CI [1.1–6.6, P=0.030])
				Adjusted odds ratio =2.7 (95% CI [1.0–6.6, P=0.041])

Note: Results are expressed as mean ± SD or n (%), adjusted odds ratio controlling for age and sex.

Abbreviations: BMI, body mass index; FEV₁, forced expiratory volume in first second; FVC, forced vital capacity; CI, confidence interval; SD, standard deviation.

Table 2 Demographic profile of chronic respiratory disease subgroups

Characteristics	Chronic rhinitis	Asthma	Rhinasthma	All asthma	COPD	Nonill
n (%)	160 (28.0)	46 (8.1)	55 (9.6)	101 (17.7)	82 (14.4)	228 (39.9)
Age (years)	50.5±8.9a	53.3±11.4a	49.2±8.2a,b	51.1±9.9a	68.1±10.4b	52.1±9.5a
Age >60 years	22 (13.8)c,d	10 (21.7)d	5 (9.1)d	15 (14.9)d	67 (81.7)c	45 (19.7)d
Male sex	46 (28.8)d	16 (34.8)d	16 (29.1)d	32 (31.7)d	49 (59.8)c	90 (39.5)d
BMI (kg/m^2)	24.2±3.5a	24.9±5.2a	25.1±4.6a	24.9±4.9a	21.1±7.0b	24.9±3.7a
Predicted FEV1 (%)	87.3±14.0a	79.1±16.6a,b	78.7±15.6a,b	78.9±15.9a,b	49.9±20.7b	87.4±12.4a
Ratio of FEV1/FVC (%)	82.2±6.2a	78.9±8.6a,b	79.4±7.3a,b	79.2±7.9a,b	52.8±10.5b	83.4±4.5a
Disease severitye
Mildf	133 (83.2)	31 (67.4)	33 (60.0)	64 (63.4)	12 (14.6)	NA
Moderate	21 (13.1)	13 (28.3)	20 (36.4)	33 (32.7)	24 (29.3)	NA
Severe	6 (3.7)	2 (4.3)	2 (3.6)	4 (3.6)	34 (41.5)	NA
Very severe	NA	NA	NA	NA	12 (14.6)	NA

Notes: Results are expressed as means ± SD or n (%);

a significantly different from COPD (independent-t-test);

b significantly different from controls (independent-t-test);

c significantly different from controls (Fisher’s exact test);

d significantly different from COPD (Fisher’s exact test);

e the severity classification of other chronic respiratory diseases was significantly different from COPD (P<0.001);

f mild severity of disease includes mild intermittent and persistent severity in patients with chronic rhinitis and asthma.

Abbreviations: COPD, chronic obstructive pulmonary disease; BMI, body mass index; FEV₁, forced expiratory volume in first second; FVC, forced vital capacity; NA, not applicable; SD, standard devaition.

Table 3 Comparison of each respiratory disease with major mood disorders

Mood disorder	Subgroups	n (%)	Adjusted OR (95% CI)	P-value
Generalized anxiety	Nonill (n=228) (ref)	11 (4.8)
	Chronic rhinitis (n=160)	22 (13.8)	2.8 (1.3–6.0)	0.008
	Asthma (n=46)	9 (19.6)	4.8 (1.8–12.3)	0.001
	Rhinasthma (n=55)	16 (29.1)	7.6 (3.3–17.9)	<0.001
	All asthma (n=101)	25 (24.8)	6.4 (2.9–13.6)	<0.001
	COPD (n=82)	14 (17.1)	4.0 (1.4–11.9)	0.011
Major depressive disorder	Nonill (n=228) (ref)	8 (3.5)
	Chronic rhinitis (n=160)	7 (4.4)	1.2 (0.4–3.5)	0.709
	Asthma (n=46)	14 (30.4)	11.9 (4.6–30.8)	<0.001
	Rhinasthma (n=55)	6 (10.9)	3.3 (1.1–10.6)	0.041
	All asthma (n=101)	20 (19.8)	7.1 (2.9–17.0)	<0.001
	COPD (n=82)	10 (12.2)	2.7 (0.8–9.0)	0.105
Panic disorder	Nonill (n=228) (ref)	6 (2.6)
	Chronic rhinitis (n=160)	6 (3.8)	1.3 (0.4–4.2)	0.628
	Asthma (n=46)	5 (10.9)	4.8 (1.4–16.7)	0.014
	Rhinasthma (n=55)	4 (7.3)	2.7 (0.7–9.9)	0.148
	All asthma (n=101)	9 (8.9)	3.6 (1.2–10.6)	0.018
	COPD (n=82)	8 (9.8)	4.4 (1.1–18.1)	0.038
At least one major mood disorder	Nonill (n=228) (ref)	44 (19.3)
	Chronic rhinitis (n=160)	50 (31.2)	1.8 (1.1–2.9)	0.014
	Asthma (n=46)	30 (65.2)	7.8 (3.9–15.5)	<0.001
	Rhinasthma (n=55)	27 (49.1)	3.9 (2.1–7.3)	<0.001
	All asthma (n=101)	57 (56.4)	5.4 (3.2–8.9)	<0.001
	COPD (n=82)	25 (30.5)	1.7 (0.8–3.5)	0.140

Note: Adjusted odds ratio controlling for age and sex.

Abbreviations: OR, odds ratio; CI, confidence interval; COPD, chronic obstructive pulmonary disease.

Table 4 Comparison of major affective disorders in patients with COPD, other CRDs, and nonill

	COPD	Asthma (n=46)	Relative risk	P-value	Adjusted	P-value
COPD vs asthma	(n=82)		(95% CI)		OR (95% CI)
Generalized anxiety disorder	14 (17.1)	9 (19.6)	0.8 (0.3–2.1)	0.725	0.3 (0.1–1.3)	0.100
Major depressive disorder	10 (12.2)	14 (30.4)	0.3 (0.1–0.8)	0.011	0.1 (0.0–0.4)	0.001
Panic disorder	8 (9.8)	5 (10.9)	0.9 (0.3–2.9)	0.841	0.2 (0.0–1.2)	0.073
At least one major affective disorder	25 (30.5)	30 (65.2)	0.2 (0.1–0.5)	<0.001	0.1 (0.0–0.3)	<0.001
	COPD	Rhinasthma	Relative risk	P-value	Adjusted	P-value
COPD vs rhinasthma	(n=82)	(n=55)	(95% CI)		OR (95% CI)
Generalized anxiety disorder	14 (17.1)	16 (29.1)	0.5 (0.2–1.1)	0.095	0.5 (0.1–1.8)	0.269
Major depressive disorder	10 (12.2)	6 (10.9)	1.1 (0.4–3.3)	0.818	0.1 (0.0–1.0)	0.055
Panic disorder	8 (9.8)	4 (7.3)	1.4 (0.4–4.8)	0.614	0.3 (0.0–3.4)	0.354
At least one major affective disorder	25 (30.5)	27 (49.1)	0.5 (0.2–0.9)	0.028	0.4 (0.1–1.2)	0.112
	COPD	All asthma	Relative risk	P-value	Adjusted	P-value
COPD vs all asthma	(n=82)	(n=101)	(95% CI)		OR (95% CI)
Generalized anxiety disorder	14 (17.1)	25 (24.8)	0.6 (0.3–1.3)	0.276	0.3 (0.1–1.3)	0.131
Major depressive disorder	10 (12.2)	20 (19.8)	0.6 (0.2–1.3)	0.228	0.1 (0.0–0.4)	0.002
Panic disorder	8 (9.8)	9 (8.9)	1.1 (0.4–3.0)	0.845	0.1 (0.0–0.9)	0.043
At least one major affective disorder	25 (30.5)	57 (56.4)	0.3 (0.2–0.6)	0.001	0.2 (0.1–0.5)	<0.001
	COPD	Chronic	Relative risk	P-value	Adjusted	P-value
COPD vs chronic rhinitis	(n=82)	rhinitis (n=160)	(95% CI)		OR (95% CI)
Generalized anxiety disorder	14 (17.1)	12 (13.8)	1.3 (0.6–2.7)	0.492	0.5 (0.2–3.7)	0.929
Major depressive disorder	10 (12.2)	7 (4.4)	3.0 (1.1–8.3)	0.024	0.4 (0.1–3.2)	0.418
Panic disorder	8 (9.8)	6 (3.8)	2.7 (0.9–8.3)	0.058	0.3 (0.2–10.4)	0.709
At least one major affective disorder	25 (30.5)	50 (31.2)	0.9 (0.5–1.7)	0.903	0.7 (0.3–2.1)	0.557
	COPD	Nonill (n=228)	Relative risk	P-value	Adjusted	P-value
COPD vs nonill	(n=82)		(95% CI)		OR (95% CI)
Generalized anxiety disorder	14 (17.1)	11 (4.8)	4.1 (1.8–9.4)	<0.001	4.0 (1.4–11.9)	0.011
Major depressive disorder	10 (12.2)	8 (3.5)	3.8 (1.5–10.0)	0.004	2.7 (0.8–9.1)	0.105
Panic disorder	8 (9.8)	6 (2.6)	4.0 (1.3–11.9)	0.008	4.4 (1.1–18.1)	0.038
At least one major affective disorder	25 (30.5)	44 (19.3)	1.8 (1.0–3.3)	0.037	1.7 (0.8–3.5)	0.140

Note: Adjusted odds ratio for age, sex, and severity of disease.

Abbreviations: COPD, chronic obstructive pulmonary disease; CRDs, chronic respiratory diseases; OR, odds ratio; CI, confidence interval.

Table 5 Comparison of COPD severity classification with major affective disorders

Mood disorder	GOLD Severity	COPD (n=82)		P-value
		n (%)	Adjusted OR (95% CI)
Generalized anxiety	Mild (n=12) (ref)	1 (8.3)
	Moderate (n=24)	3 (12.5)	2.5 (0.2–34.9)	0.502
	Severe (n=34)	9 (26.5)	0.8 (0.1–11.4)	0.833
	Very severe (n=12)	1 (8.3)	1.3 (0.6–26.9)	0.887
Major depressive disorder	Mild (n=12) (ref)	0 (0.0)
	Moderate (n=24)	2 (8.3)	NA	0.303a
	Severe (n=34)	7 (20.6)	NA	0.088a
	Very severe (n=12)	1 (8.3)	NA	0.307a
Panic disorder	Mild (n=12) (ref)	0 (0.0)
	Moderate (n=24)	0 (0.0)	NA	NA
	Severe (n=34)	6 (17.6)	NA	0.119a
	Very severe (n=12)	2 (16.7)	NA	0.140a
At least one major mood disorder	Mild (n=12) (ref)	1 (8.3)
	Moderate (n=24)	7 (29.2)	5.3 (0.5–54.9)	0.160
	Severe (n=34)	13 (38.2)	2.8 (0.3–30.9)	0.406
	Very severe (n=12)	4 (33.3)	8.3 (0.7–104.7)	0.103

Notes: Adjusted odds ratio controlling for age and sex;

a P-value using Fisher’s exact test.

Abbreviations: COPD, chronic obstructive pulmonary disease; GOLD, Global initiative for chronic Obstructive Lung Disease; OR, odds ratio; CI, confidence interval; NA, not applicable; ref, reference.