Most older patients with COPD in good mental health

ByIsabella Hornick

Fact checked byHeather Biele

A majority of adults older than 50 years with COPD had no psychiatric disorders and had good mental health, according to a study published in International Journal of Environmental Research and Public Health.

Esme Fuller-Thomson

“Most of the previous research on COPD, including my own, has focused on those who are not doing well with respect to depression and anxiety,” Esme Fuller-Thomson, PhD, director of the Institute for Life Course and Aging at the University of Toronto and professor in the Factor-Inwentash Faculty of Social Work, told Healio. “The nationally representative findings of our current study are good news that should be shared with patients and their families. Knowing that most people with COPD are happy and mentally healthy may be very reassuring for the newly diagnosed.

Brain with stethoscope — Results from this study suggest that many patients with COPD are “mentally flourishing” with more than four in every five without any psychiatric disorders and two-thirds in good mental health, according to the researchers. *Source: Adobe Stock*

“However, since one in eight older adults with COPD are dealing with a mental illness, it is still important for clinicians to screen their COPD patients and to refer those who are struggling for therapy,” Fuller-Thomson added. “Individuals who are depressed or anxious can benefit from efficacious talk therapy such as cognitive behavioral therapy.”

Fuller-Thomson and colleagues used data from the 2012 Canadian Community Health Survey–Mental Health to identify adults aged 50 years or older, 703 of whom (55.9% women) had COPD and 10,189 of whom (50.2% women) did not have COPD.

Researchers performed bivariate and logistic regression analyses to compare the mental health — measured via the absence of psychiatric disorders (APD) and complete mental health (CMH), or being free from mental illness — between these two groups. They also sought to determine the factors linked to having no psychiatric disorders and being in good mental health among patients with COPD.

To measure APD, individuals reported whether they had experienced depressive disorders, anxiety disorders, bipolar disorders, substance dependence or suicidal ideation in the past year. CMH was classified as APD in the past year plus nearly daily emotional well-being (such as life satisfaction or happiness) and high accounts of social and psychological well-being in the past month, as assessed by the Mental Health Continuum-Short Form (MHC-SF).

Overall, researchers found that patients with COPD had a significantly lower frequency of APD (86.7% vs. 95%) and CMH (66.7% vs. 77%; P < .001 for both) than individuals without COPD. Despite these differences, these results suggest that many patients with COPD are “mentally flourishing” with more than four in every five without any psychiatric disorders and two-thirds in good mental health, according to the researchers.

“COPD is a very serious and potentially fatal condition, so we were amazed to learn that the vast majority of older adults with COPD were free of any mental illness,” Fuller-Thomson told Healio.

According to researchers, several factors are linked to a greater likelihood for APD and CMH among patients with COPD, such as being married (APD OR = 2.14; 95% CI, 1.11-4.15; CMH OR = 1.64; 95% CI, 1.11-2.42), having a confidant (APD OR = 7.97; 95% CI, 3.36-18.93; CMH OR = 6.93; 95% CI, 3.32-14.47), being physically active (APD OR = 3.95; 95% CI, 1.94-8.08; CMH OR = 2.16; 95% CI, 1.47-3.17) and lacking a history of major depressive disorder (APD OR = 11.27; 95% CI, 5.22-24.34; CMH OR = 1.87; 95% CI, 1.07-3.26) or generalized anxiety disorder (APD OR = 9.93; 95% CI, 5.03-19.62; CMH OR = 3.16; 95% CI, 1.92-5.2).

Conversely, adverse childhood experiences, including abuse, neglect or domestic violence, lowered the likelihood of APD; each additional negative experience lowered the odds by 31%, according to researchers.

“We are currently studying the mental health of those with chronic pain and other chronic health conditions,” Fuller-Thomson told Healio.