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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

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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533368/
https://www.ncbi.nlm.nih.gov/pubmed/34680609
http://dx.doi.org/10.3390/biomedicines9101492
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author 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
author_facet 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
author_sort Jordan, Alexander
collection PubMed
description 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.
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spelling pubmed-85333682021-10-23 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 Biomedicines Article 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. MDPI 2021-10-18 /pmc/articles/PMC8533368/ /pubmed/34680609 http://dx.doi.org/10.3390/biomedicines9101492 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
The Association between Use of ICS and Psychiatric Symptoms in Patients with COPD—A Nationwide Cohort Study of 49,500 Patients
title The Association between Use of ICS and Psychiatric Symptoms in Patients with COPD—A Nationwide Cohort Study of 49,500 Patients
title_full The Association between Use of ICS and Psychiatric Symptoms in Patients with COPD—A Nationwide Cohort Study of 49,500 Patients
title_fullStr The Association between Use of ICS and Psychiatric Symptoms in Patients with COPD—A Nationwide Cohort Study of 49,500 Patients
title_full_unstemmed The Association between Use of ICS and Psychiatric Symptoms in Patients with COPD—A Nationwide Cohort Study of 49,500 Patients
title_short The Association between Use of ICS and Psychiatric Symptoms in Patients with COPD—A Nationwide Cohort Study of 49,500 Patients
title_sort association between use of ics and psychiatric symptoms in patients with copd—a nationwide cohort study of 49,500 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533368/
https://www.ncbi.nlm.nih.gov/pubmed/34680609
http://dx.doi.org/10.3390/biomedicines9101492
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