The Association between Use of ICS and Psychiatric Symptoms in Patients with COPD—A Nationwide Cohort Study of 49,500 Patients

Biomedicines

Anders Løkke¹  Jens Ulrik Stæhr Jensen²  Tor Biering-Sørensen²  Alexander Jordan²  Jakob B. Vestergaard²  Pradeesh Sivapalan²  Niels Seersholm²  Howraman Meteran²  Mohamad Isam Saeed²  Josefin Eklöf² 

[1] Department of Medicine, Hospital Lillebælt, 7100 Vejle, Denmark;Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark;

关键词: COPD;    ICS;    obstructive lung disease;    depression;    anxiety;    bipolar disorder;   

DOI  :  10.3390/biomedicines9101492

来源: DOAJ

【 摘 要 】

Psychiatric side effects are well known from treatment with systemic corticosteroids. It is, however, unclear whether inhaled corticosteroids (ICS) have psychiatric side effects in patients with COPD. We conducted a nationwide cohort study in all Danish COPD outpatients who had respiratory medicine specialist-verified COPD, age ≥40 years, and no previous cancer. Prescription fillings of antidepressants and risk of admissions to psychiatric hospitals with either depression, anxiety or bipolar disorder were assessed by Cox proportional hazards models. We observed a dose-dependent increase in the risk of antidepressant-use with ICS cumulated dose (HR 1.05, 95% CI 1.03–1.07, p = 0.0472 with low ICS exposure, HR 1.10, 95% CI 1.08–1.12, p < 0.0001 with medium exposure, HR 1.15, 95% CI 1.11–1.15, p < 0.0001 with high exposure) as compared to no ICS exposure. We found a discrete increased risk of admission to psychiatric hospitals in the medium and high dose group (HR 1.00, 95% CI 0.98–1.03, p = 0.77 with low ICS exposure, HR 1.07, 95% CI 1.05–1.10, p < 0.0001 with medium exposure, HR 1.13, 95% CI 1.10–1.15, p < 0.0001 with high exposure). The association persisted when stratifying for prior antidepressant use. Thus, exposure to ICS was associated with a small to moderate increase in antidepressant-use and psychiatric admissions.

【 授权许可】

Unknown