One in 17 older people with chronic obstructive pulmonary disease (COPD) experience generalised anxiety disorder (GAD), the journal COPD reports.

Canadian researchers examined 11,163 people aged at least 50 years who were interviewed during a survey of community mental health: 5.8 per cent of the 746 with COPD had experienced GAD in the year before the survey, compared to 1.7 per cent of those without COPD. After adjusting for age, sex and race, COPD patients were 3.9 times more likely to have experienced GAD.

After adjusting for sleep problems, pain and functional limitations, which accounted for most of the link, COPD patients were 1.98 times more likely to have experienced GAD. After adjusting for 18 characteristics associated with GAD, COPD patients were 72 per cent more likely to have experienced GAD. Factors that increased GAD risk in people with COPD included:

• Not having a confidant (odds ratio [OR] 7.85)
• Parental domestic violence (OR 5.63)
• Lifetime depression (OR 3.59)
• Being unmarried (OR 2.28).

The authors suggest that the “multiple issues” that influence GAD underscore the importance of multidisciplinary COPD management.

The link between GAD and COPD seems plausible. Breathlessness can indicate COPD progression, so dyspnoea can trigger anxiety. Panic attacks can, in turn, trigger breathlessness. Misinterpretation of bodily sensations, including laboured breathing, can induce panic and anxiety, while patients may experience increasingly catastrophic thoughts as COPD worsens.

^{(DOI:10.3109/15412555.2015.1132691)}