title: Chronic obstructive pulmonary disease and anxiety disorders: a nationwide population-based study in Taiwan.
abstract: Few studies have investigated the relationship between chronic obstructive pulmonary disease (COPD) and anxiety disorder outcomes. We sought to investigate the association in a large national sample.
  
  
  
  Cases were identified from Taiwan's National Health Insurance Research Database who were aged 15 years and above, with a new primary diagnosis of COPD (International Classification of Diseases, Ninth Revision codes: 491, 492, 494 and 496) between 2000 and 2007. The 29,951 cases identified were compared to 29,951 controls matched on sex, age, urban/rural residence and socioeconomic status based on insurance premium. Both groups were followed until the end of 2008 for instances of anxiety disorders. Competing risk-adjusted Cox regression analyses were applied, adjusting for matching variables, Charlson comorbidity index, hospital admission days and daily dose of prednisone.
  
  
  
  Of the 59,902 subjects, 3951 were found to have anxiety disorders during a mean (SD) follow-up period of 5.5 (2.5) years. COPD, female, urban residence, lower dose of prednisone use, depressive disorders and higher outpatient visits were independent predictors of incident anxiety disorder.
  
  
  
  COPD was associated with increased risk of an anxiety disorder diagnosis, independent of a number of potential confounding factors.
authors.affiliation: Department of Psychiatry, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan.
authors.forename: Ming-Han
authors.initials: MH
authors.lastname: Hsieh
authors.affiliation: Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Charles Tzu-Chi
authors.initials: CT
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Lutung Christian Hospital, Lukang, Taiwan.
authors.forename: Pei-Jung
authors.initials: PJ
authors.lastname: Tsai
authors.affiliation: Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chia-Jui
authors.initials: CJ
authors.lastname: Tsai
authors.affiliation: Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yin-To
authors.initials: YT
authors.lastname: Liao
authors.affiliation: Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan; Chang Gung University, Taoyuan, Taiwan. Electronic address: hjcch@yahoo.com.tw.
authors.forename: Vincent Chin-Hung
authors.initials: VC
authors.lastname: Chen
authors.affiliation: King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Anxiety; Charlson comorbidity index; Chronic obstructive pulmonary disease; Prednisone