Guillien Alicia, Laurent Lucie, Soumagne Thibaud, Puyraveau Marc, Laplante Jean-Jacques, Andujar Pascal, Annesi-Maesano Isabella, Roche Nicolas, Degano Bruno, Dalphin Jean-Charles
Research Unit EA 3920, Franche-Comté University, Besançon, France.
Department of Clinical Physiology, University Hospital, Besançon, France.
Int J Chron Obstruct Pulmon Dis. 2017 Dec 19;13:1-9. doi: 10.2147/COPD.S143883. eCollection 2018.
Chronic obstructive pulmonary disease (COPD) and farming are two conditions that have been associated with an increased risk of anxiety and depression. Dairy farming is an independent risk factor for COPD.
To test the hypotheses that the prevalence of anxiety and/or depression is higher in dairy farmers with COPD than in farmers without COPD, and higher in dairy farmers with COPD than in non-farmers with COPD.
Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale in 100 dairy farmers with COPD (DF-COPD), 98 dairy farmers without COPD (DF-controls), 85 non-farming patients with COPD (NF-COPD) and 89 non-farming subjects without COPD (NF-controls), all identified by screening in the Franche-Comté region of France. Anxiety and depression were considered present when the Hospital Anxiety and Depression Scale score was ≥8. COPD was defined by a post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio <0.7.
The crude prevalence of anxiety did not differ between the four groups, ranging from 36% in NF-controls to 47% in NF-COPD (=0.15 between groups). Similarly, the prevalence of depression did not differ significantly between the four groups (=0.16 between groups). In dairy farmers (n=198), the only factors associated with anxiety were quality of life and current smoking. Depression in dairy farmers was associated with airflow limitation (lower forced expiratory volume in 1 second and COPD grade 2 or more) as well as with some COPD-related features (dyspnea severity, current smoking, and poorer quality of life). In non-farmers, both anxiety and depression were associated with airflow limitation and COPD-related features.
In our population, the prevalence of anxiety and/or depression was similar in dairy farmers with and without COPD and in non-farmers with COPD. Nevertheless, the degree of airway obstruction and some COPD-related features were associated with depression among dairy farmers, whereas these factors were not associated with anxiety.
慢性阻塞性肺疾病（COPD）与从事农业生产这两种情况均与焦虑和抑郁风险增加有关。奶牛养殖是COPD的一个独立危险因素。
检验以下假设：患有COPD的奶农中焦虑和/或抑郁的患病率高于未患COPD的农民，且患有COPD的奶农中焦虑和/或抑郁的患病率高于患有COPD的非农民。
采用医院焦虑抑郁量表对100名患有COPD的奶农（DF-COPD）、98名未患COPD的奶农（DF-对照）、85名患有COPD的非农民患者（NF-COPD）和89名未患COPD的非农民受试者（NF-对照）进行焦虑和抑郁评估，所有这些均通过在法国弗朗什-孔泰地区进行筛查确定。当医院焦虑抑郁量表评分≥8分时，则认为存在焦虑和抑郁。COPD的定义为支气管扩张剂后1秒用力呼气容积/用力肺活量比值<0.7。
四组之间焦虑的粗患病率无差异，范围从NF-对照中的36%到NF-COPD中的47%（组间P=0.15）。同样，四组之间抑郁的患病率也无显著差异（组间P=0.16）。在奶农（n=198）中，与焦虑相关的唯一因素是生活质量和当前吸烟情况。奶农中的抑郁与气流受限（较低的1秒用力呼气容积和2级或更高级别的COPD）以及一些与COPD相关的特征（呼吸困难严重程度、当前吸烟情况和较差的生活质量）有关。在非农民中，焦虑和抑郁均与气流受限及与COPD相关的特征有关。
在我们的研究人群中，患有和未患COPD的奶农以及患有COPD的非农民中焦虑和/或抑郁的患病率相似。然而，气道阻塞程度和一些与COPD相关的特征与奶农中的抑郁有关，而这些因素与焦虑无关。
