The association between use of ics and psychiatric symptoms in patients with copd—a nationwide cohort study of 49,500 patients
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The association between use of ics and psychiatric symptoms in patients with copd—a nationwide cohort study of 49,500 patients. / Jordan, Alexander; Sivapalan, Pradeesh; Eklöf, Josefin; Vestergaard, Jakob B.; Meteran, Howraman; Saeed, Mohamad Isam; Biering-Sørensen, Tor; Løkke, Anders; Seersholm, Niels; Jensen, Jens Ulrik Stæhr.
In: Biomedicines, Vol. 9, No. 10, 1492, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - The association between use of ics and psychiatric symptoms in patients with copd—a nationwide cohort study of 49,500 patients
AU - Jordan, Alexander
AU - Sivapalan, Pradeesh
AU - Eklöf, Josefin
AU - Vestergaard, Jakob B.
AU - Meteran, Howraman
AU - Saeed, Mohamad Isam
AU - Biering-Sørensen, Tor
AU - Løkke, Anders
AU - Seersholm, Niels
AU - Jensen, Jens Ulrik Stæhr
N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021
Y1 - 2021
N2 - 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. Prescrip-tion fillings of antidepressants and risk of admissions to psychiatric hospitals with either depres-sion, 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.
AB - 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. Prescrip-tion fillings of antidepressants and risk of admissions to psychiatric hospitals with either depres-sion, 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.
KW - Anxiety
KW - Bipolar disorder
KW - COPD
KW - Depression
KW - ICS
KW - Obstructive lung disease
U2 - 10.3390/biomedicines9101492
DO - 10.3390/biomedicines9101492
M3 - Journal article
C2 - 34680609
AN - SCOPUS:85118339451
VL - 9
JO - Biomedicines
JF - Biomedicines
SN - 2227-9059
IS - 10
M1 - 1492
ER -
ID: 285514185