Psychological Functioning in Patients With Chronic Obstructive Pulmonary Disease: A Preliminary Study of Relations With Smoking Status and Disease Impact.
Psychological Functioning in Patients With Chronic Obstructive Pulmonary Disease: A Preliminary Study of Relations With Smoking Status and Disease Impact.
复制标题
慢性阻塞性肺疾病患者的心理功能：与吸烟状况和疾病影响关系的初步研究。
DOI：
10.1093/ntr/nty102
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Hitsman,Brian
中科院分区：
文献类型：
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作者：
Mathew,AmandaR;Yount,SusanE;Kalhan,Ravi;Hitsman,Brian
慢性阻塞性肺疾病（COPD）是一种与烟草相关的疾病，伴有多种共病，包括抑郁和焦虑的发生率升高。尼古丁依赖、抑郁和焦虑的心理因素可能是新的治疗靶点，但尚未在COPD患者中进行研究。我们评估了三个心理因素-焦虑敏感性（AS;对焦虑相关感觉的恐惧），痛苦不耐受（DI;无法承受痛苦状态）和快感缺乏（Anh;快乐感或兴趣减少）-与吸烟状态，COPD症状影响，方法我们对37例COPD患者进行了单次实验室评估，（17名目前每日吸烟者和20名既往吸烟者）。所有参与者完成自我报告的心理因素，COPD症状的影响，COPD症状的反应，焦虑和抑郁症状的措施。ResultsCurrent与前吸烟者COPD报告的AS，DI和Anh水平较高。在单变量回归模型中，AS、DI和Anh均与更大的COPD症状影响和呼吸困难灾难化相关。只有AS仍然是一个显着的预测COPD症状的影响和呼吸困难的灾难性调整后，一般抑郁症和焦虑symptoms.ConclusionsOur初步研究是第一次评估AS，DI，和ANH COPD患者。这些心理因素在目前吸烟者中升高，并与更多的负面疾病影响相关，这表明其作为治疗靶点的潜在效用在this clinical population.ImplicationsWhile COPD患者中焦虑和抑郁的发病率升高已被很好地描述，很少有研究专门讨论这些疾病的因果关系，可修改的心理因素。我们的初步研究结果表明，三个心理因素-AS，DI和Anh-与吸烟状态，COPD症状的影响，和症状的负面反应。针对这些心理因素的认知行为干预可能会改善COPD患者的戒烟结果和疾病调整。
IntroductionChronic obstructive pulmonary disease (COPD) is a tobacco-related disease associated with several comorbid conditions, including elevated rates of depression and anxiety. Psychological factors that commonly underlie nicotine dependence, depression, and anxiety may represent novel treatment targets, but have not yet been examined among patientswith COPD. We assessed three psychological factors—anxiety sensitivity (AS; fear of anxiety-related sensations), distress intolerance (DI; inability to withstand distressing states), and anhedonia (Anh; diminished sense of pleasure or interest)—in relation to smoking status, COPD symptom impact, and negative response to COPD symptoms.MethodsWe conducted a single-session laboratory assessment with 37 patients with COPD (17 current daily smokers and 20 former smokers). All participants completed self-report measures of psychological factors, COPD symptom impact, response to COPD symptoms, and anxiety and depression symptoms.ResultsCurrent versus former smokers with COPD reported higher levels of AS, DI, and Anh. In univariate regression models, AS, DI, and Anh were each associated with greater COPD symptom impact and breathlessness catastrophizing. Only AS remained a significant predictor of COPD symptom impact and breathlessness catastrophizing after adjusting for general depression and anxiety symptoms.ConclusionsOur preliminary study is the first to assess AS, DI, and Anh among patients with COPD. These psychological factors were elevated among current smokers and associated with more negative disease impact, suggesting their potential utility as treatment targets within this clinical population.ImplicationsWhile elevated rates of anxiety and depression among patients with COPD have been wellcharacterized, few studies have specifically addressed the causal, modifiable psychological factors that may underlie these disorders. Our preliminary findings demonstrate associations of three psychological factors—AS, DI, and Anh—with smoking status, COPD symptom impact, and negative reaction to symptoms. Cognitive-behavioral interventions targeted to these psychological factors may improve smoking cessation outcomes and disease adjustment among patients with COPD.