Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1V4, Canada.
Institute for Life Course and Aging, University of Toronto, Toronto, ON M5S 1V4, Canada.
Int J Environ Res Public Health. 2022 Dec 6;19(23):16337. doi: 10.3390/ijerph192316337.
Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and is often associated with serious disability and depression. Little is known about the characteristics of those who are in complete mental health (CMH) despite having COPD. This study’s objectives are to: (1) estimate the prevalence and odds of absence of psychiatric disorders (APD) and CMH among older adults that reported having COPD, compared to their peers that did not; (2) identify factors associated with APD and with CMH. Bivariate and logistic regression analyses were conducted using the nationally representative Canadian Community Health Survey—Mental Health. The results indicate that there was a significantly (p < 0.001) lower prevalence of APD (86.7% vs. 95.0%) and CMH (66.7% vs. 77.0%) among older adults aged 50+ with COPD (n = 703) compared to those without COPD (n = 10,189). Half of the sample was female (50.5%) and the majority of whom were under age 70 (62.5%). Factors significantly (p < 0.05) associated with higher odds of APD and of CMH among older adults with COPD include being married, having a confidant, being physically active, and having no lifetime history of major depressive disorder or generalized anxiety disorder. For every additional adverse childhood experience, the odds of APD declined by 31%. The majority of those with COPD are mentally flourishing despite having this disabling and life-threatening disorder. These findings underline the importance of targeted interventions and outreach to those most vulnerable to poorer mental health outcomes including the socially isolated.
慢性阻塞性肺疾病(COPD)是主要的死亡原因之一,常与严重残疾和抑郁有关。尽管患有 COPD,但完全心理健康(CMH)人群的特征知之甚少。本研究的目的是:(1)估计报告患有 COPD 的老年人与没有 COPD 的同龄人相比,无精神障碍(APD)和 CMH 的患病率和几率;(2)确定与 APD 和 CMH 相关的因素。使用具有全国代表性的加拿大社区健康调查-心理健康数据进行了双变量和逻辑回归分析。结果表明,在年龄在 50 岁及以上的患有 COPD 的成年人(n = 703)中,APD(86.7%比 95.0%)和 CMH(66.7%比 77.0%)的患病率显著(p < 0.001)低于没有 COPD 的成年人(n = 10,189)。该样本的一半为女性(50.5%),其中大多数年龄在 70 岁以下(62.5%)。与患有 COPD 的老年人 APD 和 CMH 几率较高相关的因素包括已婚、有知己、身体活跃,且没有终生患有重度抑郁症或广泛性焦虑症的病史。每增加一次不良的童年经历,APD 的几率就会下降 31%。尽管患有这种使人衰弱且危及生命的疾病,但大多数 COPD 患者的精神状态都很好。这些发现强调了针对那些心理健康状况较差的人(包括社会隔离者)进行有针对性的干预和外联的重要性。