Most elderly COPD patients in good mental health

05 January 2023

3 minute read

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The majority of adults over the age of 50 with COPD had no psychiatric disorders and were in good mental health, according to a study published in International journal of environmental research and public health.

Esme Fuller-Thomson

“Most previous COPD research, including my own, has focused on those who are unwell with regards to depression and anxiety,” Esme Fuller-ThomsonPhD, director of the Institute for Life Course and Aging at the University of Toronto and a professor in Factor-Inwentash’s Faculty of Social Work, he told Healio. “The nationally representative results from our current study are good news that should be shared with patients and their families. Knowing that most people with COPD are happy and mentally healthy can be very reassuring for those newly diagnosed.

Brain with stethoscope
The findings of this study suggest that many COPD patients are “mentally thriving” with more than four in five without psychiatric disorders and two-thirds in good mental health, according to the researchers. Source: AdobeStock

“However, because one in eight adults with COPD is dealing with a mental illness, it’s still important for doctors to screen their COPD patients and refer those who are struggling for treatment,” Fuller-Thomson added. “Individuals who are depressed or anxious may benefit from effective talk therapy such as cognitive behavioral therapy.”

Fuller-Thomson and colleagues used data from the 2012 Canadian Community Health Survey–Mental Health to identify adults 50 years of age and older, 703 of whom (55.9% female) had COPD and 10,189 of whom ( 50.2% women) did not have COPD.

The researchers performed bivariate and logistic regression analyzes to compare mental health — measured by the absence of psychiatric disorders (APD) and complete mental health (CMH), or the absence of mental illness — between these two groups. They also sought to determine factors related to the absence of psychiatric disorders and being in good mental health among COPD patients.

To measure APD, people reported experiencing depressive disorders, anxiety disorders, bipolar disorders, substance addiction, or suicidal ideation in the past year. CMH was rated as APD over the past year plus near-daily emotional well-being (such as life satisfaction or happiness) and high reports of social and psychological well-being over the past month, as assessed by the Mental Health Continuum-Short Form ( MHC-SF).

Overall, the researchers found that COPD patients had a significantly lower frequency of APD (86.7% vs. 95%) and CMH (66.7% vs. 77%; P < .001 for both) compared to individuals without COPD. Despite these differences, these findings suggest that many COPD patients are "mentally thriving" with more than four in five without psychiatric disorders and two-thirds in good mental health, according to the researchers.

“COPD is a very serious and potentially fatal condition, so we were surprised to learn that the vast majority of older adults with COPD were free of any mental illness,” Fuller-Thomson told Healio.

According to the researchers, several factors are linked to an increased likelihood of APD and CMH among COPD patients, such as being married (APD OR = 2.14; 95% CI, 1.11-4.15; CMH OR = 1.64; 95% CI, 1.11-2.42), having a confidant (APD OR = 7.97; 95% CI, 3.36-18.93; CMH OR = 6.93; 95% CI, 3.32-14.47), being physically active ( APD OR = 3.95; 95% CI, 1.94-8.08; CMH OR = 2.16; 95% CI, 1.47-3.17) and without a history of major depressive disorder (APD OR = 11.27; 95% CI, 5.22-24.34; CMH OR = 1.87; 95% CI, 1.07-3.26) or generalized anxiety disorder (APD OR = 9.93; 95% CI, 5.03 -19.62; CMH OR = 3.16; 95% CI, 1.92-5.2).

Conversely, adverse childhood experiences, including abuse, neglect, or domestic violence, reduced the likelihood of APD; each additional bad experience lowered the odds by 31%, according to the researchers.

“We are currently studying the mental health of those suffering from chronic pain and other chronic health conditions,” Fuller-Thomson told Healio.


For more information:

Esme Fuller-Thomson, PhD, can be reached at [email protected]

Head credit: Harry Choi

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