title: Psychological distress and chronic obstructive pulmonary disease in the Renfrew and Paisley (MIDSPAN) study.
abstract: BACKGROUND
  This study examined whether psychological distress might be a predictor of chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  The relation between psychological distress at baseline, measured by the general health questionnaire (GHQ), and chronic bronchitis three years later, as measured by the Medical Research Council (MRC) bronchitis questionnaire and forced expiratory flow in one second (FEV(1)), was examined in 1682 men and 2203 women from the Renfrew and Paisley (MIDSPAN) study. The analyses were run on men and women separately and adjustments were made for age, socioeconomic position, and lung function at baseline (FEV(1)). People with chronic diseases at baseline were then excluded to give a "healthy" baseline cohort. The effect of psychological distress on individual components of the MRC bronchitis questionnaire and FEV(1) was also assessed.
  
  
  RESULTS
  In multivariate analyses of the whole cohort baseline psychological distress in women was associated with reduced FEV(1) at follow up (OR 1.31 95% CI 1.0 to 1.73) after adjustment. In women, in the healthy cohort, psychological distress was associated with chronic bronchitis (OR 2.00, 95% CI 1.16 to 3.46), symptoms of bronchial infection (OR 2.14, 95% CI 1.44 to 3.19), symptoms of breathlessness (OR 3.02, 95% CI 1.99 to 4.59), and reduced FEV(1) (OR 1.62, 95% CI 1.13 to 2.32). In men psychological distress predicted symptoms of bronchial infection (OR 2.09, 95% CI 1.28 to 3.42).
  
  
  CONCLUSIONS
  This study supports research suggesting that psychological distress is associated with COPD and shows that psychological distress predicts COPD in women. The robustness of the association and the exact mechanism requires further investigation.
authors.affiliation: Centre of Psychiatry, The Old Anatomy Building, Wolfson Institute of Preventive Medicine, Barts and the London Queen Mary's School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK.
authors.forename: Thomas P I
authors.initials: TP
authors.lastname: Pembroke
authors.forename: Farhat
authors.initials: F
authors.lastname: Rasul
authors.forename: Carole L
authors.initials: CL
authors.lastname: Hart
authors.forename: George
authors.initials: G
authors.lastname: Davey Smith
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Stansfeld
mesh_terms: D001982:Bronchial Diseases / Q000453:epidemiology; D004417:Dyspnea / Q000453:epidemiology; D005260:Female; D005540:Forced Expiratory Flow Rates / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology*