心理困扰与 COPD 和非 COPD 患者的不良健康行为有关：来自 CanCOLD 研究的证据。
Psychological distress is related to poor health behaviours in COPD and non-COPD patients: Evidence from the CanCOLD study.
机构信息
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.
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.
出版信息
Respir Med. 2019 Jan;146:1-9. doi: 10.1016/j.rmed.2018.11.006. Epub 2018 Nov 15.
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 (β = 1.107 ± 0.197; 95%CI = 0.691-1.462; p < .001) and anxiety (β = 0.780 ± 0.170; 95%CI = 0.446-1.114; p < .001) and pack years. Higher depression (β = -0.220 ± 0.028; 95%CI = -0.275 to -0.165; p < .001) and anxiety (β = -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.
背景
患有精神障碍（抑郁、焦虑）的患者更有可能出现不良健康行为，包括更高的吸烟率和更低的身体活动（PA）水平。吸烟是慢性阻塞性肺疾病（COPD）的主要危险因素，而 PA 对 COPD 的管理至关重要。然而，尚无研究评估心理困扰与 COPD 患者和非 COPD 患者的这些行为之间的关系。这是一项评估心理障碍（抑郁、焦虑）与不良健康行为（吸烟、PA）之间关系的 CanCOLD 研究的子分析。
方法
CanCOLD 研究中的 717 例 COPD 患者和 797 例匹配的非 COPD 患者完成了医院焦虑抑郁量表（HADS），以评估焦虑和抑郁。吸烟行为通过自我报告的吸烟包年数来衡量。CHAMPS PA 问卷通过热量消耗来确定 PA 指标。回归分析确定了焦虑/抑郁与健康行为之间的关系，调整了年龄、性别、BMI、GOLD 分期和 COPD 状态。
结果
在整个样本中，我们观察到抑郁（β=1.107±0.197；95%CI=0.691-1.462；p<0.001）和焦虑（β=0.780±0.170；95%CI=0.446-1.114；p<0.001）与吸烟包年数之间存在关系。较高的抑郁（β=-0.220±0.028；95%CI=-0.275 至-0.165；p<0.001）和焦虑（β=-0.091±0.025；95%CI=-0.139 至-0.043；p<0.001）评分与较低的 PA 相关。这些关联在 COPD 和非 COPD 患者中是可比的。
结论
结果表明，较高水平的焦虑和抑郁与 COPD 患者和非 COPD 患者的吸烟量增加和 PA 水平降低有关，这表明心理困扰的症状与 COPD 和非 COPD 患者的不良健康行为也有类似的关联。未来的研究需要确定治疗心理困扰的症状是否可以改善该人群的健康行为和结局。
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