Supplementary Material for: Impact of Stressful Life Events on Patients with Chronic Obstructive Pulmonary Disease

Background: There is a general notion that stressful life events may cause mental and physical health problems. Objectives: We aimed to describe stressful life events reported by patients with chronic obstructive pulmonary disease (COPD) and to assess their impact on health outcomes and behaviors. Methods: Two hundred and sixty-six primary care patients who participated in the ICE COLD ERIC cohort study were asked to document any stressful life events in the past 3 years. We assessed the before-after (the event) changes for symptoms of depression and anxiety, health status, dyspnea-related quality of life, exacerbations, cigarette use, and physical activity. We used linear regression analysis to estimate the crude and adjusted magnitude of the before-after changes. Results: About 41% (110/266) of patients reported the experience of any stressful life events and “death of relatives/important persons” was most common (31%). After accounting for age, sex, living status, lung function, and anxiety/depression status at baseline, experiencing any stressful life events was associated with a 0.9-point increase on the depression scale (95% CI 0.3 to 1.4), a 0.8-point increase on the anxiety scale (95% CI 0.3 to 1.3), and a 0.8-point decrease in the physical activity score (95% CI –1.6 to 0). Conclusions: Experiencing stressful life events was associated with a small to moderate increase in symptoms of depression and anxiety in COPD, but no discernable effect was found for other physical outcomes. However, confirmation of these results in other COPD cohorts and identification of patients particularly vulnerable to stressful life events are needed.

背景：普遍存在一种观念，即压力性生活事件可能导致身心健康的损害。目标：本研究旨在描述慢性阻塞性肺疾病（COPD）患者报告的压力性生活事件，并评估其对健康结局和行为的影响。方法：在ICE COLD ERIC队列研究中，共有266名初级保健患者被要求记录过去3年内发生的任何压力性生活事件。我们评估了事件前后（事件发生前后的变化）抑郁和焦虑症状、健康状况、呼吸困难相关的生命质量、恶化、吸烟和体力活动方面的变化。我们使用线性回归分析来估计前后变化的粗略值和调整值。结果：大约41%（110/266）的患者报告了经历任何压力性生活事件，其中“亲友/重要人物的去世”最为常见（31%）。在考虑基线时的年龄、性别、生活状态、肺功能和焦虑/抑郁状态后，经历任何压力性生活事件与抑郁量表上的0.9分增加（95% CI 0.3至1.4）相关，与焦虑量表上的0.8分增加（95% CI 0.3至1.3）相关，以及体力活动评分的0.8分下降（95% CI -1.6至0）。结论：经历压力性生活事件与COPD患者抑郁和焦虑症状的轻度至中度增加相关，但未发现对其他物理结局有可识别的影响。然而，需要在其他COPD队列中确认这些结果，并识别出特别容易受到压力性生活事件影响的患者。