Individuals with psychosis present a reduced lung diffusion capacity and early spirometry alterations: Results from a cross-sectional study.

OBJECTIVE: Individuals with psychosis present a greater prevalence of chronic lung diseases, including Chronic Obstructive Pulmonary Disease (COPD). These chronic respiratory diseases are preceded by early lung function alterations; such as preserved ratio impaired spirometry (PRISm) or normal spirometry but low diffusion capacity of the lung for carbon monoxide (DLCO). However, there is no previous evidence on these lung function alterations in psychosis. The aim of this study is to evaluate the risk of having spirometry and DLCO alterations in subjects with psychosis compared with a control group. METHODS: Cross-sectional study on a cohort of 170 individuals including 96 subjects with psychosis and 74 sex-age-and smoking habit matched healthy controls. All subjects were under 60 years-old, and without COPD or asthma. Respiratory function was evaluated through spirometry. Clinical characteristics and DLCO values were recorded. RESULTS: Patients with psychosis showed lower spirometry results, both in terms of absolute and percentage of Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1). Absolute and percentage levels of diffusion were also lower in patients with psychosis. The percentage of individuals with DLCO<80% was higher among patients with psychosis (75% vs. 40%, p < 0.001). And the prevalence of PRISm was higher among patients with psychosis (10.4% vs. 1.4%, p < 0.001). Multivariate logistic regression analysis indicated that psychosis was an independent predictor of DLCO<80% (OR 5.67, CI95% 1.86-17.27). CONCLUSION: Patients with psychosis and females had early alterations in lung function. These results suggest that early screening for lung disease should be encouraged in psychosis.

Increased risk of early lung function alterations in people with psychosis: A cross-sectional case-control study.

BACKGROUND: Tobacco smoking has been described as the main cause of chronic obstructive pulmonary disease (COPD) and this habit is clearly more frequent among individuals with psychosis than in the general population, with rates reaching up to 60%. However, little attention has been focused on the association of COPD and psychosis. We aimed to explore the risk of presenting early lung function alterations in a group of individuals with psychosis. METHODS: Following an observational cross-sectional design we studied a cohort of individuals with established psychosis (N=128), and compared them with a sex, age, and smoking habit matched control group (N=79). We evaluated respiratory symptoms by means of mMRC, CAT and Dyspnea-12 scales. And lung function through spirometry tests. RESULTS: Individuals with psychosis presented more respiratory symptoms than controls. Similarly, we observed significant differences in the lung function tests between these two groups, where individuals with psychosis presented worse results in most of the spirometry mean values (FEV1 or forced expiratory volume in the first one second: 3.29L vs. 3.75L, p<0.001; forced vital capacity or FVC: 4.25L vs. 4.72L, p=0.002; and FEV1/FVC ratio: 0.78 vs. 0.80, p=0.052). Patients also presented worse values of lung diffusion, with lower diffusing capacity for carbon monoxide (DLCO) than controls (6.95 vs. 8.54mmol/min/kPa, p<0.001). CONCLUSIONS: The individuals with psychosis in our study presented greater respiratory symptoms and poorer lung function measured through spirometry. These signs have been described as early signs of COPD.

Evaluación del impacto sobre la actividad sexual de un programa de rehabilitación pulmonar para pacientes con enfermedad pulmonar obstructiva crónica / Assessment of the impact of pulmonary rehabilitation on sexual activity in patients with chronic obstructive pulmonary disease

ANTECEDENTES Y OBJETIVO: La enfermedad pulmonar obstructiva crónica (EPOC) limita la calidad de vida, teniendo consecuencias sobre la esfera sexual. Los programas de rehabilitación respiratoria (PRR) ayudan al tratamiento de estos pacientes. Analizamos la actividad sexual de pacientes con EPOC y los resultados de un PRR. PACIENTES Y MÉTODOS: Estudio prospectivo de cohorte única en varones diagnosticados de EPOC y candidatos a PRR. Evaluación clínica, respiratoria y analítica (T, LH, FSH, estradiol y progesterona). International Index of Erectile Function (IIEF) al inicio y tras 6 meses de PRR. Análisis descriptivo inicial, comparando parámetros respiratorios según actividad sexual. Análisis de cambios tras el PRR mediante IIEF y satisfacción mediante el cuestionario Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). RESULTADOS: Entre 2014 y 2016, 62 varones incluidos. Edad media: 66,5 años (SD 7,2); 52 exfumadores. Diez eran sexualmente activos (16,1%). No detectamos alteraciones hormonales. No apreciamos diferencias significativas en parámetros respiratorios (FEV1, test de marcha de 6 min, número de exacerbaciones, puntuación en CAT) entre pacientes sexualmente activos y no activos. Puntuación media inicial IIEF: función eréctil 8, función orgásmica 4, deseo sexual 5,6, satisfacción con relaciones 5,3 y satisfacción global 4,5. Tras PRR, aumento significativo en la puntuación total del IIEF: 6,1 (IC95% 1,9-10,3). Mejoría en todos los dominios, con cambio significativo en satisfacción con relaciones: 0,9 (IC95% 0,2-1,6). Moderada satisfacción con el tratamiento según EDITS. CONCLUSIONES: Solo un pequeño porcentaje de pacientes con EPOC incluidos en un PRR son activos sexualmente. No se aprecian diferencias respiratorias entre los pacientes activos y no activos. Los PRR provocan mejoría global en la función sexual, particularmente en la satisfacción con las relaciones

BACKGROUND AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) affects life quality, and also sexual activity. Pulmonary rehabilitation (PR) is a helpful treatment in COPD patients. The aim of this study is to assess sexual activity on COPD patients, and the effect of PR over it. PATIENTS AND METHODS: Single cohort prospective study over male COPD candidates to PR. Clinical, respiratory and biochemical assessment (FSH, LH, T, and progesterone) was performed. Patients were asked to fill baseline International Index of Erectile Function (IIEF) questionnaire, and 6 months after PR. A descriptive initial analysis compared respiratory values between patients with and without sexual activity. Changes in IIEF results were assessed after PR, and satisfaction with treatment using Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). RESULTS: Between 2014 and 2016, 62 male COPD patients enlisted. Mean age: 66.5 years (SD 7.2). 52 Ex-smokers. 10 declared being sexually active (16.1%). No hormonal levels alterations. No significant differences on respiratory parameters between sexually active and non-active patients (FEV1, 6-minutes walking test, number of exacerbations, CAT score). Baseline mean IIEF values: Erectile function 8, orgasmic function 4, sexual desire 5.6, intercourse satisfaction 5.3, and overall satisfaction 4.5. After PR, significant increase in mean IIEF value: 6.1 (CI95% 1.9-10.3). Improvement was found in all domains, with statistical significance on intercourse satisfaction 0.9 (CI95% 0.2-1.6). Moderate satisfaction with treatment was achieved according to EDITS. CONCLUSIONS: Only a low percentage of COPD males included in PR is sexually active. No pulmonary differences were found between sexually active and non-active patients. PR improves sexual function, particularly intercourse satisfaction domain

Information Needs in COPD After an Educational Programme: Influence in Exacerbations and Admissions.

Introduction: Improving patients' information needs (IN) may contribute to better control in COPD. This study analyses IN using Lung Information Needs Questionnaire (LINQ) following an educational intervention, evaluates how clinical characteristics modify IN, and studies high IN as a prognostic factor for COPD exacerbations and hospital admissions. Methods: Cohort of 143 patients with initial diagnosis of COPD included in a structured educational program. Two months after completing the program, IN was assessed using LINQ. Correlations between IN and clinical variables of COPD and distribution of IN in different clinical groups were analyzed. Univariate and multivariate analysis was performed to determine influence of IN on exacerbations and COPD admissions over the following year. Results: LINQ scored 6.3±2.9. There were no differences in LINQ scoring between different clinical groups, but LINQ score positively correlated with age (r=0.184, p=0.029). High IN was a predictor of COPD hospitalizations (HR 2.3 [95% CI 1.1-5.1] (p=0.029)) but not of less severe exacerbations (p=0.334). Conclusion: IN was not associated with any clinical variables, but it correlated with age. High IN proved to be an independent predictor of admissions.

[Assessment of the impact of pulmonary rehabilitation on sexual activity in patients with chronic obstructive pulmonary disease]. / Evaluación del impacto sobre la actividad sexual de un programa de rehabilitación pulmonar para pacientes con enfermedad pulmonar obstructiva crónica.

BACKGROUND AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) affects life quality, and also sexual activity. Pulmonary rehabilitation (PR) is a helpful treatment in COPD patients. The aim of this study is to assess sexual activity on COPD patients, and the effect of PR over it. PATIENTS AND METHODS: Single cohort prospective study over male COPD candidates to PR. Clinical, respiratory and biochemical assessment (FSH, LH, T, and progesterone) was performed. Patients were asked to fill baseline International Index of Erectile Function (IIEF) questionnaire, and 6 months after PR. A descriptive initial analysis compared respiratory values between patients with and without sexual activity. Changes in IIEF results were assessed after PR, and satisfaction with treatment using Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). RESULTS: Between 2014 and 2016, 62 male COPD patients enlisted. Mean age: 66.5 years (SD 7.2). 52 Ex-smokers. 10 declared being sexually active (16.1%). No hormonal levels alterations. No significant differences on respiratory parameters between sexually active and non-active patients (FEV1, 6-minutes walking test, number of exacerbations, CAT score). Baseline mean IIEF values: Erectile function 8, orgasmic function 4, sexual desire 5.6, intercourse satisfaction 5.3, and overall satisfaction 4.5. After PR, significant increase in mean IIEF value: 6.1 (CI95% 1.9-10.3). Improvement was found in all domains, with statistical significance on intercourse satisfaction 0.9 (CI95% 0.2-1.6). Moderate satisfaction with treatment was achieved according to EDITS. CONCLUSIONS: Only a low percentage of COPD males included in PR is sexually active. No pulmonary differences were found between sexually active and non-active patients. PR improves sexual function, particularly intercourse satisfaction domain.

Papel de la rehabilitación respiratoria enla deshabituación tabáquica / Role of respiratory rehabilitation in smoking cessation

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Traducción y validación del cuestionario multidimensional Disnea-12 / Translation and Validation of the Multidimensional Dyspnea-12 Questionnaire

Introducción: La disnea es un síntoma con un componente multidimensional, aunque las herramientas que se utilizan habitualmente para evaluarla no tienen en cuenta esta faceta. El cuestionario Disnea-12 valora la multidimensionalidad de la disnea, específicamente las dimensiones afectiva y sensorial. El objetivo de este estudio es validar el cuestionario Disnea-12 al español. Métodos: Se realizó una traducción del original en inglés al español y del español al inglés para verificar la equivalencia del texto. Posteriormente se verificó la comprensión del texto tras pasárselo a 10 pacientes. La fiabilidad y la validez del cuestionario se estudiaron en un grupo independiente de EPOC diagnosticados y clasificados por las guías GOLD de las consultas externas de neumología del Hospital Universitario Marqués de Valdecilla. Resultados: El grupo (n = 51) tenía una media de edad de 65 años y un FEV1 medio del 50%. Todos los pacientes entendieron las preguntas del cuestionario. El instrumento presentó consistencia interna de alfa = 0,937 y un coeficiente de correlación intraclase: 0,969; p<0,001. Se encontraron correlaciones estadísticamente significativas con las puntuaciones del HAD (HADansiedad r = 0,608 y HADdepresión r = 0,615), disnea de la mMRC (r = 0,592), T6MM (r = -0,445), FEV1 (r = -0,312), las 4 dimensiones de CRQ-SAS (disnea r = -0,626; fatiga r = -0,718; función emocional r = -0,663; control de enfermedad r = -0,740), el CAT (r = 0,669) y el índice de disnea basal (r = -0,615). Los grupos GOLD más sintomáticos (B y D) presentaron una puntuación 10,32 puntos mayor en el Disnea-12 (p < 0,001). Conclusión: El cuestionario Disnea-12 es un instrumento válido y fiable para evaluar la disnea de forma multidimensional (AU)

Introduction: Dyspnea is a multidimensional symptom, but this multidimensionality is not considered in most dyspnea questionnaires. The Dyspnea-12 takes a multidimensional approach to the assessment of dyspnea, specifically the sensory and the affective response. The objective of this study was to translate into Spanish and validate the Dyspnea-12 questionnaire. Methods: The original English version of the Dyspnea-12 questionnaire was translated into Spanish and backtranslated to analyze its equivalence. Comprehension of the text was verified by analyzing the responses of 10 patients. Reliability and validation of the questionnaire were studied in an independent group of COPD patients attending the pulmonology clinics of Hospital Universitario Marqués de Valdecilla, diagnosed and categorized according to GOLD guidelines. Results: The mean age of the group (n = 51) was 65 years and mean FEV1 was 50%. All patients understood all questions of the translated version of Dyspnea-12. Internal consistency of the questionnaire was alfa=0.937 and intraclass correlation coefficient was = .969; P < .001. Statistically significant correlations were found with HADS (anxiety r = .608 and depression r = .615), mMRC dyspnea (r = .592), 6MWT (r = -0.445), FEV1 (r = -0.312), all dimensions of CRQ-SAS (dyspnea r = -0.626; fatigue r = -0.718; emotional function r = -0.663; mastery r = -0.740), CAT (r = 0.669), and baseline dyspnea index (r = -0.615). Dyspnea-12 scores were 10.32 points higher in symptomatic GOLD groups (B and D) (P < .001). Conclusion: The Spanish version of Dyspnea-12 is a valid and reliable instrument to study the multidimensional nature of dyspnea (AU)

Translation and Validation of the Multidimensional Dyspnea-12 Questionnaire. / Traducción y validación del cuestionario multidimensional Disnea-12.

INTRODUCTION: Dyspnea is a multidimensional symptom, but this multidimensionality is not considered in most dyspnea questionnaires. The Dyspnea-12 takes a multidimensional approach to the assessment of dyspnea, specifically the sensory and the affective response. The objective of this study was to translate into Spanish and validate the Dyspnea-12 questionnaire. METHODS: The original English version of the Dyspnea-12 questionnaire was translated into Spanish and backtranslated to analyze its equivalence. Comprehension of the text was verified by analyzing the responses of 10 patients. Reliability and validation of the questionnaire were studied in an independent group of COPD patients attending the pulmonology clinics of Hospital Universitario Marqués de Valdecilla, diagnosed and categorized according to GOLD guidelines. RESULTS: The mean age of the group (n=51) was 65 years and mean FEV1 was 50%. All patients understood all questions of the translated version of Dyspnea-12. Internal consistency of the questionnaire was α=0.937 and intraclass correlation coefficient was=.969; P<.001. Statistically significant correlations were found with HADS (anxiety r=.608 and depression r=.615), mMRC dyspnea (r=.592), 6MWT (r=-0.445), FEV1 (r=-0.312), all dimensions of CRQ-SAS (dyspnea r=-0.626; fatigue r=-0.718; emotional function r=-0.663; mastery r=-0.740), CAT (r=0.669), and baseline dyspnea index (r=-0.615). Dyspnea-12 scores were 10.32 points higher in symptomatic GOLD groups (B and D) (P<.001). CONCLUSION: The Spanish version of Dyspnea-12 is a valid and reliable instrument to study the multidimensional nature of dyspnea.