Depression, anxiety, and COPD: the unexamined role of nicotine dependence.
BACKGROUND
Previous studies have shown links between anxiety and depression and chronic obstructive pulmonary disease (COPD), but little is known about possible mechanisms of this association. The current study examined whether the observed relationship between anxiety and depression and COPD is explained by confounding due to cigarette smoking and lifetime nicotine dependence.


METHODS
Data were drawn from the National Comorbidity Survey Replication, a community-based representative sample of adults in the United States.


RESULTS
Analyses suggest that the association between anxiety disorders and COPD appears to be largely explained by confounding by former cigarette smoking and lifetime nicotine dependence. The association between mood disorders and COPD appears to be largely explained by confounding by lifetime nicotine dependence.


CONCLUSIONS
These findings provide initial evidence suggesting that the association between anxiety, depression, and COPD may be at least partly attributable to confounding by cigarette smoking and nicotine dependence. Efforts toward prevention of chronic lung disease may be more effective if treatment and prevention efforts aimed at smoking cessation address mental health problems.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1505, New York, NY 10032, USA. rdg66@columbia.edu
Renee D
RD
Goodwin
Kim L
KL
Lavoie
Adina R
AR
Lemeshow
Elizabeth
E
Jenkins
E Sherwood
ES
Brown
David A
DA
Fedoronko
D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000139:chemically induced / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000139:chemically induced / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D010698:Phobic Disorders / Q000139:chemically induced / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult