title: Associations between DSM-IV mental disorders and subsequent COPD diagnosis.
abstract: OBJECTIVE
  COPD and mental disorder comorbidity is commonly reported, although findings are limited by substantive weaknesses. Moreover, few studies investigate mental disorder as a risk for COPD onset. This research aims to investigate associations between current (12-month) DSM-IV mental disorders and COPD, associations between temporally prior mental disorders and subsequent COPD diagnosis, and cumulative effect of multiple mental disorders.
  
  
  METHODS
  Data were collected using population surveys of 19 countries (n=52,095). COPD diagnosis was assessed by self-report of physician's diagnosis. The World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) was used to retrospectively assess lifetime prevalence and age at onset of 16 DSM-IV disorders. Adjusting for age, gender, smoking, education, and country, survival analysis estimated associations between first onset of mental disorder and subsequent COPD diagnosis.
  
  
  RESULTS
  COPD and several mental disorders were concurrently associated across the 12-month period (ORs 1.5-3.8). When examining associations between temporally prior disorders and COPD, all but two mental disorders were associated with COPD diagnosis (ORs 1.7-3.5). After comorbidity adjustment, depression, generalized anxiety disorder, and alcohol abuse were significantly associated with COPD (ORs 1.6-1.8). There was a substantive cumulative risk of COPD diagnosis following multiple mental disorders experienced over the lifetime.
  
  
  CONCLUSIONS
  Mental disorder prevalence is higher in those with COPD than those without COPD. Over time, mental disorders are associated with subsequent diagnosis of COPD; further, the risk is cumulative for multiple diagnoses. Attention should be given to the role of mental disorders in the pathogenesis of COPD using prospective study designs.
authors.affiliation: Department of Psychological Medicine, University of Otago, Dunedin, New Zealand. Electronic address: charlene.rapsey@otago.ac.nz.
authors.forename: Charlene M
authors.initials: CM
authors.lastname: Rapsey
authors.affiliation: Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Carmen C W
authors.initials: CC
authors.lastname: Lim
authors.affiliation: College of Medicine, Al-Qadisiya University, Diwania governorate, Iraq.
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Hamzawi
authors.affiliation: IMIM-Institut Hospital del Mar d'Investigacions Mèdiques) CIBER en Epidemiolgía y Salud Pública (CIBERESP) UPF-Pompeu Fabra University, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.affiliation: University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Belgium.
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.affiliation: Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal.
authors.forename: J M
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.affiliation: National School of Public Health, Management and Professional Development, Bucharest, Romania; Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Institute of Hygiene, Poland.
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.affiliation: IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.affiliation: Shenzhen Insitute of Mental Health & Shenzhen Kanging Hospital, PRC - Shenzhen.
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, United States.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France.
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
authors.affiliation: Ministry of Health Israel, Mental Health Services, Israel.
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.affiliation: Nacional Institute of Psychiatry Ramon de la Fuente, Mexico.
authors.forename: María Elena
authors.initials: ME
authors.lastname: Medina-Mora
authors.affiliation: School of Psychology, University of Ulster, Northern Ireland.
authors.forename: Sam
authors.initials: S
authors.lastname: Murphy
authors.affiliation: Center for Cognitive Behavior Therapy and Research, National Center for Neurology and Psychiatry, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institute of Health, Peru.
authors.forename: Maria
authors.initials: M
authors.lastname: Piazza
authors.affiliation: Colegio Mayor de Cundinamarca University, Colombia.
authors.forename: Jose
authors.initials: J
authors.lastname: Posada-Villa
authors.affiliation: Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: ten Have
authors.affiliation: Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Institute of Hygiene, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Wojtyniak
authors.affiliation: Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D055815:Young Adult
keywords: Alcohol abuse; Anxiety disorders; COPD; Comorbidity; Depression