TY - JOUR T1 - Depressive symptoms among patients with chronic obstructive pulmonary disease according to smoking status – a Danish nationwide case-control study of 21 184 patients JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00036-2020 SP - 00036-2020 AU - Jakob Hedemark Vestergaard AU - Pradeesh Sivapalan AU - Rikke Sørensen AU - Josefin Eklöf AU - Imane Achir Alispahic AU - Anna von Bülow AU - Niels Seersholm AU - Jens-Ulrik Stæhr Jensen Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/early/2020/09/10/23120541.00036-2020.abstract N2 - Introduction Depressive symptoms appear more often among patients with chronic obstructive pulmonary disease (COPD) and are associated with reduced disease control and increased mortality. Both smoking and COPD increase the risk of depressive symptoms. Whether smoking cessation among COPD patients affects the occurrence of depressive symptoms is unknown. We hypothesised that smoking cessation in patients with COPD leads to reduced use of antidepressants and fewer admissions to psychiatric hospitals with depression, anxiety or bipolar disorder.Methods We conducted a nationwide retrospective case-control study, in patients from The Danish Register for Chronic Obstructive Pulmonary Disease (DrCOPD) with spirometry verified COPD, age ≥40 years, a history of smoking and absence of cancer. Consistent smokers were matched 1:1 with ex-smokers using a propensity score model. Prescription fillings of antidepressants and risk of admissions to psychiatric hospitals with either depression, anxiety or bipolar disorder both descriptively was assessed by Cox proportional hazard models.Results We included 21 184 patients. A total of n=2011 consistent smokers collected antidepressant prescriptions compared with 1821 ex-smokers. Consistent smoking was associated with increased risk of filling prescription on antidepressants (HR 1.4, 95% CI 1.3–1.5, p<0.0001). and with increased risk of psychiatric hospital admission with either depression, anxiety or bipolar disorder (HR 2.0, 95% CI 1.6–2.5). The associations persisted after adjustment for former use of antidepressants.Conclusion Consistent smoking among COPD patients was associated with increased use of antidepressants and admissions to psychiatric hospitals with either depression, anxiety or bipolar disorder, compared to smoking cessation.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Vestergaard has nothing to disclose.Conflict of interest: P. Sivapalan reports nonfinancial support from Novartis and honoraria for lecturing from Boehringer Ingelheim outside the submitted work.Conflict of interest: Dr. Sørensen has nothing to disclose.Conflict of interest: Dr. Eklöf has nothing to disclose.Conflict of interest: Dr. Alispahic has nothing to disclose.Conflict of interest: Dr. von Bülow has nothing to disclose.Conflict of interest: Dr. Seersholm has nothing to disclose.Conflict of interest: Dr. Jensen has nothing to disclose. ER -