Anxiety and depression in end-stage COPD (original) (raw)
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Anxiety and depression in chronic obstructive pulmonary disease: A new intervention and case report
Cognitive and Behavioral Practice, 2005
Anxzety and depmsston coexist frequently zn chronzc obstructwe pulmona~:y dzsease and compound the tmpact of the dzsease on quality of bfe and functzonal status Howev~ httle attentzon has been gwen to the development of treatment strategtes for thzs subset of patzents. The current artzcle describes the development of a new, mult~component cognztzve behavzoral treatment for reduczng anxzety and depresswn among patzents wtth respiratory dzsease (CBT-RADAR). Outcome data from a group of 5 patzents who partzczpated zn an ongoing clzn~cdl thai are revzewed to dlu~trate the strengths and hmztatlons of thzs mterventwn C HRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) is a serious and progressive medical illness with a profound impact on life function, economic burden, and mortality. Physical symptoms include shortness of breath, chest pain, cough, weakness, fatigue, poor exercise tolerance, nutritional abnormalities, and damage to the heart and brain. The disease affects 14 to 20 million people and is the fourth leading cause of death in the United States (Centers for Disease Control, 2003). Hospital readmission occurs frequently, and general rates of service use are high (Centers for Disease Control, 2005). Associated economic costs are estimated at $24 billion per year (Sullivan, Ramsey, & Lee, 2000). Quality of life and functional status are severely impaired as a result of both the physical symptoms and limitations of COPD and frequently coexistent psychological difficulties. Coexistent anxiety and depression are particularly common in COPD (Borson, Claypoole, & McDonald, 1998, Brenes, 2003). In many cases, the symptoms of COPD overlap with those of anxiety or depression (e.g., sleep disturbance, decreased energy, shortness of breath, and catastrophic thoughts about physical symptoms) and differential diagnosis is difficult. Nevertheless, anxiety and depressive diagnoses have been established via chnical interview in 16% to 34% of patients with COPD
Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), estimates of their prevalence vary considerably. This probably reflects the variety of scales and methods used to measure such symptoms. Regardless of whether anxiety and depression are considered separately or as a single construct, their impact on COPD patients is important. A heightened experience of dyspnoea is likely to be a contributing factor to anxiety. Feelings of depression may be precipitated by the loss and grief associated with the disability of COPD. Smoking has been associated with nicotine addiction, and the factors that contribute to smoking may also predispose to anxiety and depressive disorders. Randomised controlled trials indicate that exercise training and carefully selected pharma- cological therapy are often effective in ameliorating anxiety and depression. Most medical illnesses are influenced by the psychological responses and coping mechani...
Anxiety and depression-Important psychological comorbidities of COPD
Journal of thoracic disease, 2014
Anxiety and depression are common and important comorbidities in patients with chronic obstructive pulmonary disease (COPD). The pathophysiology of these psychological comorbidities in COPD is complex and possibly explained by common risk factors, response to symptomatology and biochemical alterations. The presence of anxiety and/or depression in COPD patients is associated with increased mortality, exacerbation rates, length of hospital stay, and decreased quality of life and functional status. There is currently no consensus on the most appropriate approach to screening for anxiety and depression in COPD. Treatment options include psychological [relaxation, cognitive behavioural therapy (CBT), self-management] and pharmacological interventions. Although there is some evidence to support these treatments in COPD, the data are limited and mainly comprised by small studies. Pulmonary rehabilitation improves anxiety and depression, and conversely these conditions impact rehabilitation...
Depression and anxiety in patients with COPD
Under-recognised and untreated depression and anxiety symptoms have deleterious effects on physical functioning and social interaction increasing fatigue and healthcare utilisation in patients with chronic obstructive pulmonary disease (COPD). Depression and anxiety are challenging to identify and treat because their symptoms often overlap with those of COPD. The cause(s) of depression and anxiety symptoms are multifactorial and include behavioural, social and biological factors. Less than one-third of COPD patients with comorbid depression or anxiety symptoms are receiving appropriate treatment. Factors that contribute to the lack of provision of treatment are varied, they include patient perceived barriers, for example lack of knowledge and reluctance to receive antidepressant drug therapy; poor treatment compliance and lack of a standardised diagnostic approach; and scarcity of adequate resources for mental health treatment.
Depression and Anxiety in cases of COPD
IP Innovative Publication Pvt. Ltd, 2017
Patients with chronic obstructive pulmonary disease (COPD) have many times under-recognized and untreated depression and anxiety symptoms which lead to harmful effects on physical functioning and social interaction. Depression and anxiety are often difficult to identify in patients of COPD. The causes for these associated diseases in COPD are multifactorial including social, behavioural and biological factors. Less than 35% of COPD patients with these co-morbid diseases are receiving appropriate treatment. The factor for this low treatment rate includes patients perceived barrier e.g. reluctance to receive antidepressant drug therapy, poor treatment compliance and deficiency of standardized diagnostic approach. There are inconclusive evidence to support the efficacy of anti-depressant drug therapy in patients of COPD with comorbid depression and anxiety. Promising results are being noticed in pulmonary rehabilitation, psychological therapy and the collaborative care model in reducing depression and anxiety symptoms in patients with COPD. But, the main limitations are short term follow up period. More research is required to establish the efficacy of these interventions in randomized control trial with larger samples and longer follow up periods.
Anxiety and Depression in COPD
CHEST Journal, 2008
Background-Approximately 60 million people in the United States live with one of four chronic conditions: heart disease, diabetes, chronic respiratory disease, and major depression. Anxiety and depression are very common comorbidities in COPD and have significant impact on patients, their families, society, and the course of the disease.
Journal of clinical and diagnostic research : JCDR, 2017
Anxiety and depression are important but often under-diagnosed co-morbid conditions in patients with Chronic Obstructive Pulmonary Disease (COPD) which may affect the functional capacity of the patients. To find out the proportion of depression and anxiety among stable COPD patients using a validated questionnaire suitable for use in clinic and the factors affecting their reduced functional capability as assessed by six-minute walk test. This was a descriptive cross-sectional study. Seventy five patients diagnosed with stable COPD in outpatient Department of Pulmonary Medicine in a tertiary care hospital, satisfying all inclusion criteria, were included in the study. They were examined clinically, categorized as per Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity assessment guideline and interviewed by designated interviewer using validated questionnaire for depression (Hamilton depression rating scale, HAM-D) and anxiety (State Trait Anxiety Inventory, STAI)....
Strategies to improve anxiety and depression in patients with COPD: a mental health perspective
Neuropsychiatric Disease and Treatment, 2016
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by progressive and only partially reversible symptoms. Worldwide, the incidence of COPD presents a disturbing continuous increase. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Pharmacological treatment based on selective serotonin reuptake inhibitors has almost replaced tricyclic antidepressants. The main psychological intervention is cognitive behavioral therapy. Of particular interest are pulmonary rehabilitation programs, which can reduce anxiety and depressive symptoms in these patients. Although the literature on treating anxiety and depression in patients with COPD is limited, we believe that it points to the implementation of personalized strategies to address their psychopathological comorbidities.
Respirology, 2012
Chronic obstructive pulmonary disease (COPD) is a serious contemporary health issue. Psychological co-morbidities such as anxiety and depression are common in COPD. Current evidence for treatment options to reduce anxiety and depression in patients with COPD was examined. There is evidence available for the efficacy of pharmacological treatments, cognitive behavioural therapy, pulmonary rehabilitation, relaxation therapy and palliative care in COPD. Therapeutic modalities that have not been proven effective in decreasing anxiety and depression in COPD, but which have theoretical potential among patients, include interpersonal psychotherapy, self-management programmes, more extensive disease management programmes, supportive therapy and self-help groups. Besides pulmonary rehabilitation that is only available for a small percentage of patients, management guidelines make scant reference to other options for the treatment of mental health problems. The quantity and quality of research on mental health treatments in COPD have historically been insufficient to support their inclusion in COPD treatment guidelines. In this review, recommendations regarding assessment, treatment and future research in this important field were made.