Associations between DSM-IV mental disorders and subsequent COPD diagnosis

Charlene M. Rapsey, Carmen C W Lim, Ali Al-Hamzawi, Jordi Alonso, Ronny Bruffaerts, J. M. Caldas-de-Almeida, Silvia Florescu, Giovanni de Girolamo, Chiyi Hu, Ronald C. Kessler, Viviane Kovess-Masfety, Daphna Levinson, María Elena Medina-Mora, Sam Murphy, Yutaka Ono, Maria Piazza, Jose Posada-Villa, Margreet Ten Have, Bogdan Wojtyniak, Kate M. Scott

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12 Citations (Scopus)


Objectives: 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.

Original languageEnglish
Pages (from-to)333-339
Number of pages7
JournalJournal of Psychosomatic Research
Issue number5
Publication statusPublished - Nov 2015


  • Alcohol abuse
  • Anxiety disorders
  • Comorbidity
  • COPD
  • Depression


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