Newswise: Chronic obstructive pulmonary disease (COPD), a debilitating chronic lung disease that includes emphysema and chronic bronchitis, has previously been linked to mental health problems including depression, anxiety, and substance use disorders. But a new study by researchers at the University of Toronto found that even though adults without the disease were improving mentally at higher rates, a vast majority of those diagnosed with COPD had excellent mental health.
The study investigated factors associated with mental flourishing in a nationally representative sample of 703 Canadians over the age of 50 who had been diagnosed with COPD, the third leading cause of death in Canada. It found that 87% of older Canadians with COPD were found to be free of mental illness, while two-thirds (67%) of those with COPD were in excellent mental health.
“This research provides a very hopeful message for people battling COPD, as well as their families and healthcare professionals,” says co-author Sally Abudiab, a recent graduate of the U of Factor-Inwentash School of Social Work. T. “Our findings suggest “The vast majority of people with COPD are embracing their lives and thriving. They enjoy exceptionally good mental health despite the physical, mental and financial challenges of coping with COPD.”
The researchers wanted to investigate the factors associated with a high level of mental well-being. To be defined as excellent mental health, respondents had to achieve three things: 1) nearly daily happiness or life satisfaction in the past month, 2) high levels of social and psychological well-being in the past month, and 3) being free of general disorders. anxiety disorder and depressive disorders, suicidal thoughts, and substance dependence for at least the previous full year.
People with COPD who were socially isolated were particularly vulnerable to poorer mental health. On the other hand, those who had at least one person in their life with whom they could talk about important decisions were seven times more likely to be free of mental illness and to have excellent mental health compared to those without a confidant.
“It is clear that social support is a key factor in the well-being of older adults with COPD. Interventions are needed to promote social support and decrease social isolation and loneliness among the most isolated,” says Abudiab.
Factors associated with lower levels of flourishing included previous major depressive disorders and adverse childhood experiences. Older Canadians with COPD who had experienced major depressive disorder or generalized anxiety disorder at some point in the past were much less likely to be happy and flourishing than those with COPD without this history.
Additionally, adverse childhood experiences, such as physical and sexual abuse, reduced the odds that people with COPD would not have a mental illness by 31%. Childhood adversities can impede the development of positive coping strategies and emotional regulation, and exacerbate maladaptive attachment styles, such as smoking and substance abuse, in adulthood, ultimately compromising physical and mental health.
“Our findings underscore the importance of targeted outreach and referrals for people with COPD who are not thriving,” says the study’s lead author, Esme Fuller-Thomson. “Health care professionals may want to consider mental health interventions such as cognitive behavioral therapy (CBT) for older adults with COPD who are struggling with their mental health. CBT has been shown to be highly effective in reducing symptoms of mental illness in COPD patients who also have depression and anxiety, and has also been used successfully in people with a history of childhood adversity.” Fuller-Thomson is director of the U of T Institute for the Life Course and Aging and a professor in the Factor-Inwentash College of Social Work and in the Department of Family and Community Medicine.
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