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Psychological distress and chronic obstructive pulmonary disease in the Renfrew and Paisley (MIDSPAN) study
  1. Thomas P I Pembroke1,
  2. Farhat Rasul2,
  3. Carole L Hart2,
  4. George Davey Smith3,
  5. Stephen A Stansfeld1
  1. 1Centre for Psychiatry, Wolfson Institute of Preventive Medicine Bart’s and the London, Queen Mary’s School of Medicine and Dentistry, University of London, London, UK
  2. 2Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, Glasgow, UK
  3. 3Department of Social Medicine, University of Bristol, Bristol, UK
  1. Correspondence to:
 Professor S A Stansfeld
 Centre of Psychiatry, The Old Anatomy Building, Wolfson Institute of Preventive Medicine, Barts and the London Queen Mary’s School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK; s.a.stansfeld{at}


Background: This study examined whether psychological distress might be a predictor of chronic obstructive pulmonary disease (COPD).

Method: The relation between psychological distress at baseline, measured by the general health questionnaire (GHQ), and chronic bronchitis three years later, as measured by the Medical Research Council (MRC) bronchitis questionnaire and forced expiratory flow in one second (FEV1), was examined in 1682 men and 2203 women from the Renfrew and Paisley (MIDSPAN) study. The analyses were run on men and women separately and adjustments were made for age, socioeconomic position, and lung function at baseline (FEV1). People with chronic diseases at baseline were then excluded to give a “healthy” baseline cohort. The effect of psychological distress on individual components of the MRC bronchitis questionnaire and FEV1 was also assessed.

Results: In multivariate analyses of the whole cohort baseline psychological distress in women was associated with reduced FEV1 at follow up (OR 1.31 95% CI 1.0 to 1.73) after adjustment. In women, in the healthy cohort, psychological distress was associated with chronic bronchitis (OR 2.00, 95% CI 1.16 to 3.46), symptoms of bronchial infection (OR 2.14, 95% CI 1.44 to 3.19), symptoms of breathlessness (OR 3.02, 95% CI 1.99 to 4.59), and reduced FEV1 (OR 1.62, 95% CI 1.13 to 2.32). In men psychological distress predicted symptoms of bronchial infection (OR 2.09, 95% CI 1.28 to 3.42).

Conclusion: This study supports research suggesting that psychological distress is associated with COPD and shows that psychological distress predicts COPD in women. The robustness of the association and the exact mechanism requires further investigation.

  • COPD, chronic obstructive pulmonary disease
  • FEV1, forced expiratory flow in one second
  • MRC, Medical Research Council
  • psychological distress
  • GHQ
  • chronic obstructive pulmonary disease
  • MIDSPAN study

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  • Funding: Farhat Rasul was funded by the British Heart Foundation for the initial analysis of psychological morbidity in the Renfrew and Paisley (MIDSPAN) study from grant number (PG/98170). Thomas Pembroke wrote this paper while studying for a BMedSci.

  • Conflicts of interest: none.

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