Specific psychiatric morbidity among patients with chronic obstructive pulmonary disease in a Nigerian general hospital
Introduction
Chronic obstructive pulmonary disease (COPD) is an important cause of mortality and morbidity worldwide, and its exacerbations commonly lead to hospital admissions [1]. As the world population ages [2], the significance of COPD for the health care system is growing [3]. Although, COPD is a chronic physical illness, it has profound psychological and social impact on its victims [4]. Among the psychiatric disorders identified in COPD population in western societies are generalized anxiety disorder, panic disorder and depressive episode [5], [6], [7].
The risk factors of developing COPD are cigarette smoking, history of respiratory disease, low socioeconomic status, rural dwelling and the use of biofuel [8], [9], [10], [11], [12], [13]. These factors are prevalent in Nigeria [14], [15]. Unfortunately, studies are lacking on the psychosocial aspects of COPD from this country, which is the most populous African nation. One cannot extrapolate research findings from western societies to developing countries with completely different socioeconomic and sociocultural characteristics. It is therefore necessary to explore the psychiatric aspect of COPD and the sociodemographic factors influencing it in a West African setting.
Section snippets
Method
This study was conducted between September 1997 and August 1998 at the Respiratory Unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Thirty consecutive patients with COPD, comprising of 25 males and 5 females, seen at the unit, were recruited for the study. Diagnosis of COPD was based on the following criteria: (1) an unequivocal history of chronic exertional dyspnoea, chronic cough and sputum production on most days for at least 3 months for 2 consecutive
The sociodemographic characteristics of the studied populations
Comparing the three groups showed no significant differences with regards to marital status, religion and income (Table 1). However, with regards to education and occupation, there were significant differences when the three groups were compared (χ2=15.79, df=2, P<.001 and χ2=14.85, df=2, P<.001, respectively). Specifically, the educational attainments of the hypertensive and healthy control groups were not significantly different but that of the COPD patients was significantly lower than that
Discussion
In this study, a majority of the COPD patients were uneducated and functioned as subsistent farmers. This group of people is often rural dwellers, in marginal living conditions, cook with firewood and lack access to basic health care facilities. These findings clearly indicate that preventive strategies against COPD should be directed at the rural population.
The psychiatric morbidity complicating COPD in this index population (30%) was significantly higher than those of the comparison groups.
Acknowledgements
The authors are grateful to Prof. Jude U. Ohaeri, the medical superintendent of St. Giles Hospital Suva Fiji Islands, for his useful suggestions.
References (36)
- et al.
Oral corticosteroids in patients admitted to hospital with exacerbations of chronic obstructive pulmonary disease: a prospective randomised controlled trial
Lancet
(1999) - et al.
Emergency department return visits in chronic obstructive pulmonary disease: the importance of psychosocial factors
Ann Emerg Med
(1991) The use of tobacco products among Nigerian adults: a general population survey
Drug Alcohol Depend
(1990)- et al.
Demographic/socioeconomic factors in mental disorders associated with tuberculosis in southwest Nigeria
J Psychosom Res
(1998) - et al.
Predicting cognitive decline in patients with hypoxaemic COPD
Respir Med
(1998) Psychosocial issues in chronic obstructive pulmonary disease
Clin Chest Med
(1986)- et al.
Illness perceptions, coping and functioning in patients with rheumatic arthritis, chronic obstructive pulmonary disease and psoriasis
J Psychosom Res
(1998) Current thoughts regarding treatment of chronic obstructive pulmonary disease
Med Clin North Am
(1996)- et al.
Age distribution of patients treated in hospital for chronic obstructive pulmonary disease
Age Ageing
(1996)