1 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom; Montréal Behavioural Medicine Centre, Centre intégrée universitaire de services de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal, Québec, Canada.
2 Montréal Behavioural Medicine Centre, Centre intégrée universitaire de services de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal, Québec, Canada; Department of Exercise Science, Concordia University, Montréal, Québec, Canada.
3 Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
4 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
5 Montréal Behavioural Medicine Centre, Centre intégrée universitaire de services de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, Montréal, Québec, Canada; Department of Psychology, University of Québec at Montréal, Montréal, Québec, Canada. Electronic address: lavoie.kim@uqam.ca.
6 Ottawa University, Ottawa, Ontario, Canada.
7 University of Toronto, Toronto, Ontario, Canada.
8 University of British Columbia, Vancouver, British Columbia, Canada.
9 Dalhousie University, Halifax, Nova Scotia, Canada.
10 University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
11 Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Quebec, Canada.
12 Queens University, Kingston, Ontario, Canada.
13 University of Calgary, Calgary, Alberta, Canada.

Psychological distress is related to poor health behaviours in COPD and non-COPD patients: Evidence from the CanCOLD study.

Respir Med. 2019 Jan;146:1-9

Authors: Paine NJ, Bacon SL, Bourbeau J, Tan WC, Lavoie KL, CanCOLD Study Investigators, Aaron SD, Chapman KR, FitzGerald JM, Hernandez P, Marciniuk DD, Maltais F, O'Donnell DE, Sin D, Walker BL, Canadian Respiratory Research Network and teh CanCOLD Collaborative Research Group

Abstract

BACKGROUND: Patients with psychiatric disorders (depression, anxiety) are more likely to have poor health behaviours, including higher smoking and lower physical activity (PA) levels. Smoking is a major risk factor for Chronic Obstructive Pulmonary Disease (COPD), and PA is critical for COPD management. However, no studies have assessed associations between psychological distress and these behaviours among patients with vs without COPD. This is a sub-analysis of the CanCOLD study that assessed the relationships between psychological disorders (depression, anxiety) and poor health behaviours (smoking, PA).

METHODS: 717 COPD and 797 matched non-COPD individuals from the CanCOLD study, completed the Hospital Anxiety Depression Scale (HADS) to assess anxiety and depression. Smoking behaviour was self-reported pack-years smoking. The CHAMPS PA questionnaire determined calorific expenditure as a PA measure. Regressions determined relationships between anxiety/depression and health behaviours, adjusting for age, sex, BMI, GOLD stage and COPD status.

RESULTS: Across the whole sample, we observed relationships between depression (ß?=?1.107?±?0.197; 95%CI?=?0.691-1.462; p?<?.001) and anxiety (ß?=?0.780?±?0.170; 95%CI?=?0.446-1.114; p?<?.001) and pack years. Higher depression (ß?=?-0.220?±?0.028; 95%CI?=?-0.275 to -0.165; p?<?.001) and anxiety (ß?=?-0.091?±?0.025; 95%CI?=?-0.139 to -0.043; p?<?.001) scores were related to lower PA. These associations were comparable across COPD and non-COPD patients.

CONCLUSIONS: Results showed that higher levels of anxiety and depression were related to higher cumulative smoking and lower levels of PA in patients with and without COPD, suggesting symptoms of psychological distress is similarly associated with poorer health behaviours in COPD and non-COPD individuals. Future studies need to determine if treating symptoms of psychological distress can improve health behaviours and outcomes in this population.

PMID: 30665505 [PubMed - in process]