Mental disorders and quality of life in COPD patients and their spouses

Figures & data

Table 1 Sample characteristics

	Patients (n = 143)			Spouses (n = 105)
Age (years)	67.0 ± 9.5 range: 40–90			64.0 ± 9.3 range: 43–84
Gender (F:M)	31:112 (21.7 : 78.3%)			19:86 (81.9 : 18.1%)
Marital status
Single	8 (5.5%)
Separated	11 (7.7%)
Widowed	14 (9.8%)
Married	110 (76.9%)			105 (100%)
Years of marriage	37.8 ±12.8			range: 4–66
Education
≤9 years	110 (76.9%)			86 (80.1%)
10 years	19 (13.3%)			14 (9.8%)
13 years	14 (9.8%)			5 (3.5%)
COPD severity	FEV1% pred	SWT	Comorbid heart disease
2 n = 68 (47.6 %)	62.9 ± 9.6	402 ± 241	n = 30 (44.1%)
3 n = 62 (43.4 %)	40.8 ± 5.3	219 ± 161	n = 28 (45.2%)
4 n = 13 (9.1 %)	26.4 ± 2.8	118 ± 133	n = 5 (38.5%)

Data presented as n, mean ± SD

Abbreviations: FEV₁% pred, forced expiratory volume in 1 second expressed in percentage predicted; SWT, shuttle walking test (in meters); comorbid heart disease, coronary heart disease, myocardial infarction or cardiac failure.

Table 2 Comorbid mental disorders in COPD patients and their spouses

		2 representative samples			Significance Pearson’s χ^2
	Patients (n = 143)	BASE (n = 516)	NMHWS (n = 1792)	Spouses (n = 105)	BASE/Patients	BASE/Spouses
Anxiety/depression diagnoses:
Depressive disorder	17 (11.9 %)	4.8 %	1.1 %	18 (17.1 %)	p < .003	p < .001
Dysthymia	3 (2.1 %)	2.0 %	0.1 %	4 (2.8 %)	n.s.	n.s.
Panic disorder and/or agoraphobia	11 (7.7 %)	0.8 %	0.5 %	5 (4.8 %)	p < .001	p < .001
Generalized anxiety disorder	8 (5.6 %)	0.9 %	1.7 %	7 (6.7 %)	p < .001	p < .001
Alcohol dependence or harmful use:
At present	11 (7.7 %)	1.2 %	0.3 %	1 (1.0 %)	p < .001	n.s.
Lifetime	14 (9.8 %)			2 (2.0 %)
Non-existent	118 (82.5 %)			102 (97.1 %)
Nicotine dependence or abuse:
At present	31 (21.7 %)	not assessed		23 (21.9 %)
Former smoker	105 (73.4 %)			17 (16.2 %)
Non-smoker	7 (4.9 %)			65 (61.9 %)

Abbreviations: BASE, German Aging Study (data are DSM-III-R diagnoses according to Wernicke et al 2000); NMHWS, national mental health and well-being-survey (data according to Trollor et al 2007).

Table 3 Comparison of means in COPD patients with and without mental disorders

	Patients with mental disorder (n = 28)		Patients without mental disorder (n = 115)
	M	SD	M	SD	test statistics	df	Sig. 1-sided
Gendera (F:M)	8 : 20		23 : 90				n.s
Age (years)	67.0	9.6	64.0	9.3			n.s.
SWT	298	221	297	227			n.s.
FEV1% pred	50.3	15.6	50.0	14.8			n.s.
SGRQ
Symptoms	57.7	25.1	63.8	22.9			n.s.
Activities	65.2	25.6	60.0	22.6			n.s.
Impact	64.9	37.1	49.1	30.1	−2.37	141	0.010
Total score	64.8	29.1	53.8	24.6	−2.04	141	0.022
EuroQolb	43.9	29.5	51.8	19.9			n.s.
CDI	5.27	2.83	4.25	2.86			n.s.

Test statistics are t-tests, if not otherwise specified.

a χ²;

b Mann-Whitney U-Score.

Abbreviations: SWT, shuttle walking test; FEV₁% pred, forced expiratory volume in 1 second expressed in percentage predicted; SGRQ, st. george’s respiratory questionnaire; EuroQol, european quality of life questionnaire; CDI, COPD-disability-index.

Table 4 Stepwise multiple linear regressions

criterion: health-related quality of life in patients (SGRQ-T)
Model A: only patient variables			Model B: patient and spouse variables
Significant Predictors:	β	p	Significant Predictors:	β	p
P-Depression (SCL-90-R)	0.32	<0.001	P-Somatizationa (SCL-90-R)	0.22	0.015
Walking distance (SWT)	−0.36	<0.001	Walking distance (SWT)	−0.53	<0.001
P-Somatizationa (SCL-90-R)	0.27	<0.001	P-Depression (SCL-90-R)	0.30	<0.001
P-Gender (1 = F; 2 = M)	0.14	0.009	S-Anxiousness (SCL-90-R)	0.16	0.024
FEV1% pred	−0.15	0.014	P-Gender (1 = F; 2 = M)	0.14	0.028
Heart disease	0.13	0.027
Excluded variables:			Excluded variables:
SCL-90-R: P-Anxiousness, P-Phobic anxiety; P-depression/anxiety diagnoses			FEV1% pred; heart disease; S-Gender; SCL-90-R: S-Somatization, S-Depression, S-Phobic anxiety
criterion: COPD-related disability in spouses (S-CDI)
Model C: patient variables from model A			Model D: patient variables from model C plus SGRQ scores
Significant Predictors:	β	p	Significant Predictors:	β	p
P-Somatizationa (SCL-90-R)	0.24	0.057	Impact (SGRQ)	0.46	<0.001
Walking distance (SWT)	−0.36	0.016	P-Somatizationa (SCL-90-R)	0.22	0.024
P-Depression (SCL-90-R)	0.27	0.020
Excluded variables:			Excluded variables:
SCL-90-R: P-Anxiousness, P-Phobic anxiety; P-Gender; P-depression/anxiety diagnoses; FEV1 pred; heart disease			SCL-90-R: P-Depression; Walking distance (SWT); FEV1% pred; heart disease; P-Gender; SGRQ: symptoms, activities; S-Gender

a Scale without original items: chest pain/difficulties breathing

β = Stand. β –coefficient.

Abbreviations: FEV₁% pred, forced expiratory volume in 1 second expressed in percentage predicted; SWT, shuttle walking test; SCL-90-R, symptom-checklist-90-R; SGRQ, st. george’s respiratory questionnaire; P-…, patient variables; S-…, spouse variables.

Figure 1 Diagnoses that warrant further consideration.

WernickeTFLindenMGilbergR2000Ranges of psychiatric morbidity in the old and the very old results from the Berlin Aging Study (BASE)Eur Arch Psychiatry Clin Neurosci250111910941985

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TrollorJNAndersonTMSachdevPS2007Prevalence of mental disorders in the elderly: The Australian National Mental Health and Well-Being-SurveyAm J Geriatr Psychiatry154556617545446

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