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Chronic obstructive pulmonary disease patients with psychiatric disorders are at greater risk of exacerbations.
Psychosom Med 2009; 71(6):667-74PM

Abstract

OBJECTIVE

To assess prospectively the impact of psychiatric disorders on risk for exacerbations. The course of chronic obstructive pulmonary disease (COPD) is punctuated by acute exacerbations. Although anxiety and mood disorders are common in patients with COPD, no studies have assessed prospectively the association between these disorders and exacerbations.

METHODS

Psychiatric disorders were evaluated by a structured psychiatric interview in 110 patients (51% women, age (mean +/- standard deviation) = 66 +/- 8 years) with stable COPD and previous admission for exacerbations recruited from two outpatient clinics. Patients were followed for a mean of 2 years and both inpatient-treated (i.e., treated in the emergency department or hospital) and outpatient-treated (i.e., treated with medication in the patient's own environment) exacerbations were recorded.

RESULTS

Independent of covariates, patients with psychiatric disorders exhibited a significantly higher weighted annual rate of exacerbations treated in an outpatient setting after adjustment for covariates (3 versus 2, p = .003) than patients without psychiatric disorders, but no difference in exacerbations treated in the inpatient setting. They were also at a higher risk for any (relative risk (RR) = 1.56, 95% Confidence Interval (CI) = 1.02-2.37) and outpatient (RR = 1.68, 95% CI = 1.08-2.59) exacerbations, but not inpatient exacerbations (RR = 1.36, 95% CI = 0.82-2.25).

CONCLUSIONS

Patients with psychiatric disorders are at greater risk of exacerbations treated in an outpatient setting but not those treated in an inpatient setting. These outpatient-managed exacerbations account for a significant proportion of the healthcare burden for COPD, so interventions should target patients with psychiatric disorders to improve management of COPD.

Authors+Show Affiliations

Department of Psychology, University of Québec at Montreal (UQAM), Canada. k-lavoie@crhsc.rtss.qc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19561164

Citation

Laurin, Catherine, et al. "Chronic Obstructive Pulmonary Disease Patients With Psychiatric Disorders Are at Greater Risk of Exacerbations." Psychosomatic Medicine, vol. 71, no. 6, 2009, pp. 667-74.
Laurin C, Labrecque M, Dupuis G, et al. Chronic obstructive pulmonary disease patients with psychiatric disorders are at greater risk of exacerbations. Psychosom Med. 2009;71(6):667-74.
Laurin, C., Labrecque, M., Dupuis, G., Bacon, S. L., Cartier, A., & Lavoie, K. L. (2009). Chronic obstructive pulmonary disease patients with psychiatric disorders are at greater risk of exacerbations. Psychosomatic Medicine, 71(6), pp. 667-74. doi:10.1097/PSY.0b013e3181a82849.
Laurin C, et al. Chronic Obstructive Pulmonary Disease Patients With Psychiatric Disorders Are at Greater Risk of Exacerbations. Psychosom Med. 2009;71(6):667-74. PubMed PMID: 19561164.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic obstructive pulmonary disease patients with psychiatric disorders are at greater risk of exacerbations. AU - Laurin,Catherine, AU - Labrecque,Manon, AU - Dupuis,Gilles, AU - Bacon,Simon L, AU - Cartier,André, AU - Lavoie,Kim L, Y1 - 2009/06/26/ PY - 2009/6/30/entrez PY - 2009/6/30/pubmed PY - 2009/8/20/medline SP - 667 EP - 74 JF - Psychosomatic medicine JO - Psychosom Med VL - 71 IS - 6 N2 - OBJECTIVE: To assess prospectively the impact of psychiatric disorders on risk for exacerbations. The course of chronic obstructive pulmonary disease (COPD) is punctuated by acute exacerbations. Although anxiety and mood disorders are common in patients with COPD, no studies have assessed prospectively the association between these disorders and exacerbations. METHODS: Psychiatric disorders were evaluated by a structured psychiatric interview in 110 patients (51% women, age (mean +/- standard deviation) = 66 +/- 8 years) with stable COPD and previous admission for exacerbations recruited from two outpatient clinics. Patients were followed for a mean of 2 years and both inpatient-treated (i.e., treated in the emergency department or hospital) and outpatient-treated (i.e., treated with medication in the patient's own environment) exacerbations were recorded. RESULTS: Independent of covariates, patients with psychiatric disorders exhibited a significantly higher weighted annual rate of exacerbations treated in an outpatient setting after adjustment for covariates (3 versus 2, p = .003) than patients without psychiatric disorders, but no difference in exacerbations treated in the inpatient setting. They were also at a higher risk for any (relative risk (RR) = 1.56, 95% Confidence Interval (CI) = 1.02-2.37) and outpatient (RR = 1.68, 95% CI = 1.08-2.59) exacerbations, but not inpatient exacerbations (RR = 1.36, 95% CI = 0.82-2.25). CONCLUSIONS: Patients with psychiatric disorders are at greater risk of exacerbations treated in an outpatient setting but not those treated in an inpatient setting. These outpatient-managed exacerbations account for a significant proportion of the healthcare burden for COPD, so interventions should target patients with psychiatric disorders to improve management of COPD. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/19561164/Chronic_obstructive_pulmonary_disease_patients_with_psychiatric_disorders_are_at_greater_risk_of_exacerbations_ L2 - http://Insights.ovid.com/pubmed?pmid=19561164 DB - PRIME DP - Unbound Medicine ER -