Psychiatric comorbidities and smoking behavior in chronic obstructive pulmonary disease: A case–control study from a north Indian tertiary Center

Background: Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a condition with multisystem involvement, including psychiatric comorbidities. Tobacco smoking, a primary etiological factor for COPD, may also predispose individuals to psychological distress. Aims and Objectives: To assess the prevalence and pattern of psychiatric comorbidities in COPD patients, evaluate smoking history, and analyze their associations with COPD severity. Materials and Methods: A case–control study was conducted involving 221 COPD patients and 221 age-and gender-matched controls. Demographic profiles, smoking history (including pack-years), and psychiatric assessments were recorded. Psychiatric diagnoses were established using standard clinical interviews based on international classification of diseases, 10th edition criteria. Statistical analysis was performed using Chi-square tests to determine associations, with significance set at P<0.05. Results: Cases exhibited significantly higher rates of smoking, with regular smokers constituting 51.1% compared to 14.0% of controls (P=0.0001). Psychiatric comorbidities were substantially elevated in cases, notably dysthymia (35.29% vs. 17.65%; P=0.0002), generalized anxiety disorder (41.63% vs. 21.72%; P=0.0001), and recurrent depressive disorder (29.86% vs. 13.57%; P=0.0001). Higher COPD severity grades were associated with increased psychiatric morbidity (P<0.05). Conclusion: COPD is strongly associated with a higher burden of psychiatric comorbidities and tobacco exposure. Integrating psychiatric evaluation into COPD management could enhance holistic patient care.