title: Chronic bronchitis, cigarette smoking, and the subsequent onset of depression and anxiety: results from a prospective population-based cohort study.
abstract: OBJECTIVE
  The authors used data from a prospective, population-based cohort study to examine: (a) whether the presence of chronic bronchitis predicts the subsequent onset of depression or anxiety, and (b) if the incidence of depressed or anxious cases was different for smokers compared with nonsmokers.
  
  
  METHODS
  For studying the relation between chronic bronchitis and anxiety or depression, we used data from respectively 4468 and 4520 respondents.
  
  
  RESULTS
  The number of incident anxious (19.1%, n = 17) and depressed (14.0%, n = 13) cases was highest in employees with chronic bronchitis compared with employees without respiratory complaints (4.3%, n = 189 and 3.3%, n = 145, respectively). The presence of chronic bronchitis was associated with a significant increase in anxious and depressed cases (odds ratio (OR) for anxiety = 5.09, 95% confidence interval (CI) 2.91, 8.89; OR for depression = 4.38, 95% CI 2.35, 8.16). The incidence of anxiety as well as depression was strongest in the smokers group (OR for anxiety = 8.94, 95% CI 4.08, 19.59; OR for depression = 7.56, 95% CI 3.37, 16.96).
  
  
  CONCLUSIONS
  This prospective study shows significantly higher levels of anxiety as well as depression in employees with chronic bronchitis. Results also seem to indicate that smoking cigarettes modifies this association, resulting in an increased risk of depression and anxiety in employees with chronic bronchitis who smoke.
authors.affiliation: Pulmonary Rehabilitation Centre Hornerheide, Haelen, Horn, The Netherlands. edwinwagena@proteion.nl
authors.forename: Edwin J
authors.initials: EJ
authors.lastname: Wagena
authors.forename: Ludovic G P M
authors.initials: LG
authors.lastname: van Amelsvoort
authors.forename: Ijmert
authors.initials: I
authors.lastname: Kant
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D029481:Bronchitis, Chronic / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000523:psychology*; D012907:Smoking / Q000523:psychology*