title: Mental health problems, obstructive lung disease and lung function: findings from the general population.
abstract: OBJECTIVE
  There is cumulative evidence for a strong association of obstructive lung disease, i.e. asthma and COPD, with poor mental health, particularly with anxiety disorders and major depression. However, studies relating mental health problems to objective measures of lung function as assessed by spirometry are lacking.
  
  
  METHODS
  The 12-month prevalence of specific psychopathological syndromes among 1772 adults from the general population was estimated by a structured interview. Additionally, participants underwent spirometry and were asked about obstructive lung disease in the year prior to the study. Logistic and linear regression models were used to relate obstructive lung disease and spirometrically defined airway obstruction to mental health problems.
  
  
  RESULTS
  Mental health problems were found in 35.7% of the participants. After adjusted for sociodemographic, clinical and life-style factors, asthma and chronic bronchitis were associated with almost all domains of mental health problems. In contrast, independent of its definition, spirometric airflow limitation was only related to generalized anxiety (odds ratios ranging from 2.3 to 2.7). A reduced ratio of forced expiratory volume in one second to forced vital capacity was associated with mental health problems in general and panic and general anxiety in particular.
  
  
  CONCLUSIONS
  Our findings suggest an association of objective measure of airflow limitation to generalized anxiety and panic. While the causal relationship between obstructive lung disease, airflow limitation and anxiety remains to be determined, clinicians should pay diagnostic attention to the significant overlap of these conditions.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Hamburg, Germany. c.spitzer@uke.uni-hamburg.de
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.forename: Sven
authors.initials: S
authors.lastname: Gläser
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Grabe
authors.forename: Ralf
authors.initials: R
authors.lastname: Ewert
authors.forename: Sven
authors.initials: S
authors.lastname: Barnow
authors.forename: Stephan B
authors.initials: SB
authors.lastname: Felix
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Freyberger
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Beate
authors.initials: B
authors.lastname: Koch
authors.forename: Christoph
authors.initials: C
authors.lastname: Schäper
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D013147:Spirometry