Uikey Mahendra S, Dayal Prabhoo
Psychiatry, All India Institute of Medical Sciences, New Delhi, IND.
National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, IND.
Cureus. 2023 Apr 17;15(4):e37688. doi: 10.7759/cureus.37688. eCollection 2023 Apr.
Introduction Smoking cessation is the most effective approach to slowing down the progression of chronic obstructive pulmonary disease (COPD). Despite this, almost half of COPD patients continue to smoke after diagnosis. COPD patients with current smoking status are more likely to have concurrent psychiatric comorbidities, for instance, depression and anxiety. These psychiatric disorders can contribute to the persistence of smoking in individuals with COPD. This study aimed to investigate predictors of smoking persistence in COPD patients. Materials and methods A cross-sectional study was conducted in the Outpatient Department (OPD) of the Department of Pulmonary Medicine in a tertiary care hospital from August 2018 to July 2019. Patients with COPD were screened for their smoking status. All subjects were then personally assessed for any psychiatric comorbidity using the Mini International Neuropsychiatric Interview (MINI), the Patient Health Questionnaire-9 (PHQ-9), and the Anxiety Inventory for Respiratory (AIR) Disease. Logistic regression was performed to compute the odds ratio (OR). Results The study included a total of 87 COPD patients. Of the 87 COPD patients, 50 were current smokers, and 37 were past smokers. COPD patients with psychiatric disorders were four times more likely to continue smoking than those without psychiatric comorbidities (OR: 4.62, 95% CI: 1.46-14.54). The results showed that increasing PHQ-9 scores by one unit in COPD patients increased the likelihood of continuing to smoke by 27 percent. Conclusion In our multivariate analysis, current depression was found as a significant predictor of continued smoking in COPD patients. The present results are consistent with reports from previous research that depressive symptoms are associated with continued smoking in patients with COPD. COPD patients who are currently smoking should be examined for psychiatric disorders and treated concurrently to achieve effective smoking cessation.
引言
戒烟是减缓慢性阻塞性肺疾病(COPD)进展的最有效方法。尽管如此,几乎一半的COPD患者在确诊后仍继续吸烟。目前仍在吸烟的COPD患者更有可能同时患有精神疾病合并症,例如抑郁症和焦虑症。这些精神障碍会导致COPD患者持续吸烟。本研究旨在调查COPD患者持续吸烟的预测因素。
材料与方法
2018年8月至2019年7月,在一家三级护理医院的呼吸内科门诊进行了一项横断面研究。对COPD患者进行吸烟状况筛查。然后使用迷你国际神经精神访谈(MINI)、患者健康问卷9(PHQ-9)和呼吸系统疾病焦虑量表(AIR)对所有受试者进行个人精神疾病合并症评估。进行逻辑回归以计算比值比(OR)。
结果
该研究共纳入87例COPD患者。在这87例COPD患者中,50例为当前吸烟者,37例为既往吸烟者。患有精神疾病的COPD患者继续吸烟的可能性是没有精神疾病合并症患者的四倍(OR:4.62,95%CI:1.46-14.54)。结果表明,COPD患者的PHQ-9评分每增加一个单位,继续吸烟的可能性就增加27%。
结论
在我们的多变量分析中,发现当前的抑郁症是COPD患者持续吸烟的一个重要预测因素。目前的结果与先前研究报告一致,即抑郁症状与COPD患者持续吸烟有关。目前仍在吸烟的COPD患者应接受精神疾病检查并同时进行治疗,以实现有效的戒烟。