Sex differences in the prevalence of psychiatric disorders and psychological distress in patients with COPD

Background: Psychiatric disorders are highly prevalent in patients with COPD. In general, psychiatric disorders are more common in women than in men. The extent to which women with COPD suffer from greater psychiatric and psychological morbidity is not known. The present cross-sectional study evaluated the prevalence of mood and anxiety disorders, levels of psychological distress, and quality of life in 62 women and 54 men with documented, stable COPD. Methods: All patients (n = 116) underwent a sociodemographic and medical history interview, followed by a structured psychiatric interview and standard spirometry. Patients also completed a battery of questionnaires measuring psychological distress and quality of life. Results: The overall prevalence of psychiatric disorders was 49%. Significantly more women than men met the diagnostic criteria for anxiety disorders (56% vs 35%), and a trend for greater levels of major depression in women was found (18% vs 7%). Women had significantly higher anxiety sensitivity and depressive symptoms compared to men but did not report more limitations in psychological functioning. Women also reported being less confident in their ability to control respiratory symptoms, and more daily physical limitations compared to men, despite having comparable COPD severity, dyspnea scores, and exacerbation rates. Conclusions: Results indicate that psychiatric disorders are at least three times higher in COPD patients compared to the general population, and nearly two times higher in women than in men. Women also have greater psychological distress, worse perceived control of symptoms, and greater functional impairment. Greater efforts should be made to identify and treat psychiatric disorders in COPD patients, particularly in women.