Anxiety and depression among dairy farmers: the impact of COPD
Received 13 June 2017
Accepted for publication 4 October 2017
Published 19 December 2017 Volume 2018:13 Pages 1—9
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Richard Russell
Alicia Guillien,1 Lucie Laurent,2 Thibaud Soumagne,3 Marc Puyraveau,4 Jean-Jacques Laplante,5 Pascal Andujar,6 Isabella Annesi-Maesano,7 Nicolas Roche,8,9 Bruno Degano,1,* Jean-Charles Dalphin3,*
1Research Unit EA 3920, Franche-Comté University, Besançon, France; 2Department of Clinical Physiology, University Hospital, Besançon, France; 3Department of Respiratory Diseases, University Hospital, Besançon, France; 4Clinical Methodology Center, University Hospital, Besançon, France; 5Department of Occupational Diseases, Mutualité sociale agricole, Besançon, France; 6University of Medical Sciences, Paris-est Créteil University, Créteil, France; 7Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Paris, France; 8Respiratory and Intensive Care Medicine, Cochin Hospital (AP-HP), University Paris Descartes, Paris, France; 9Research Unit EA 2511, University Paris Descartes, Paris, France
*These authors contributed equally to this work
Background: Chronic obstructive pulmonary disease (COPD) and farming are two conditions that have been associated with an increased risk of anxiety and depression. Dairy farming is an independent risk factor for COPD.
Objective: To test the hypotheses that the prevalence of anxiety and/or depression is higher in dairy farmers with COPD than in farmers without COPD, and higher in dairy farmers with COPD than in non-farmers with COPD.
Methods: Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale in 100 dairy farmers with COPD (DF-COPD), 98 dairy farmers without COPD (DF-controls), 85 non-farming patients with COPD (NF-COPD) and 89 non-farming subjects without COPD (NF-controls), all identified by screening in the Franche-Comté region of France. Anxiety and depression were considered present when the Hospital Anxiety and Depression Scale score was ≥8. COPD was defined by a post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio <0.7.
Results: The crude prevalence of anxiety did not differ between the four groups, ranging from 36% in NF-controls to 47% in NF-COPD (p=0.15 between groups). Similarly, the prevalence of depression did not differ significantly between the four groups (p=0.16 between groups). In dairy farmers (n=198), the only factors associated with anxiety were quality of life and current smoking. Depression in dairy farmers was associated with airflow limitation (lower forced expiratory volume in 1 second and COPD grade 2 or more) as well as with some COPD-related features (dyspnea severity, current smoking, and poorer quality of life). In non-farmers, both anxiety and depression were associated with airflow limitation and COPD-related features.
Conclusion: In our population, the prevalence of anxiety and/or depression was similar in dairy farmers with and without COPD and in non-farmers with COPD. Nevertheless, the degree of airway obstruction and some COPD-related features were associated with depression among dairy farmers, whereas these factors were not associated with anxiety.
Keywords: COPD, farmers, forced expiratory volume in 1 second, Hospital Anxiety and Depression Scale, St George’s Respiratory Questionnaire
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