Anxiety Disorders

Depression and Anxiety in COPD: The Role of the Psychiatrist

Avatar photoBatya Swift Yasgur, MA, LSW
|

 

Nonpharmacologic Therapies                      

Psychological therapies have been found to be as effective as antidepressants in patients with COPD and preferred by many patients.16 Cognitive-behavioral therapy can help “decrease the sensation of dyspnea, and can also address symptoms of anxiety and depression,” Borson said.

Collaborative care has been studied and found effective in reducing symptoms of depression and anxiety and increasing adherence to COPD therapy.13 The role of the psychiatrist in collaborative care is to provide caseload supervision, clinical advice, and decision support to mental health and allied health professionals and primary care physicians.3

Even in the absence of a formal collaborative care program, psychiatrists should still work collaboratively with the patient’s primary physician or respiratory care specialist, said Borson.

Additional effective interventions include pulmonary rehabilitation, counseling, exercise, smoking cessation, relaxation therapy, supportive psychotherapy, yoga, social support, respite care for caregivers, and telephone health mentoring.10

Related Content

Conclusion

“COPD is a progressive condition, creating increasing major limitations in everyday life,” Borson said. “One of the important roles a psychiatrist can play is to help patients figure out how to cope with this, and develop a new type of life that is also rewarding and pleasurable. Psychiatrists should be on the lookout for patients who need this type of help.”

Batya Swift Yasgur MA, LMSW, is a psychotherapist and freelance writer who lives in Teaneck, N.J. She practices therapy in New York City.

References

1.      Centers for Disease Control and Prevention. National Center for Health Statistics. National Vital Statistics Report. Deaths: Final Data for 2010. May 2013; 61(04).

2.      American Lung Association. Chronic obstructive pulmonary disease (COPD) fact sheet. (2014) Available at: http://www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html. Accessed: May 8, 2015.

3.      Maurer J, et al. Anxiety and depression in COPD: Current understanding, unanswered questions, and research needs. Chest. 2008;134(4 Suppl):43S-56S.

4.      Solano JP, et al. A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. J Pain Symptom Manage. 2006;31(1):58-69.

5.      Kim HF, et al. Functional impairment in COPD patients: the impact of anxiety and depression. Psychosomatics. 2000;41(6):465-71.

6.      Kunik ME, et al. Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest. 2005;127(4):1205-1211.

7.      Lu Y, et al. Systemic inflammation, depression and obstructive pulmonary function: a population-based study. Respir Res. 2013;14:53.

8.      Valkanova V, et al. CRP, IL-6 and depression: a systematic review and meta-analysis of longitudinal studies. J Affect Disord. 2013;150(3):736-744.

9.      Bailey PH. The dyspnea-anxiety-dyspnea cycle–COPD patients’ stories of breathlessness: “It’s scary /when you can’t breathe”. Qual Health Res. 2004;14(6):760-778.

10.  Yohannes AM and Alexopoulos GS. Depression and anxiety in patients with COPD. Eur Respir Rev. 2014;23:345-349.

11.  Fleehart S, et al. Prevalence and correlates of suicide ideation in patients with COPD: a mixed methods study. Int J Chron Obstruct Pulmon Dis. 2014;9:1321-1329.

12.  Torres-Sánchez I, et al. Cognitive impairment in COPD: a systematic review. J Bras Pneumol. 2015;41(2):182-190.

13.  Yohannes AM and Alexopoulos GS. Pharmacological treatment of depression in older patients with chronic obstructive pulmonary disease: impact on the course of the disease and health outcomes. Drugs Aging. 2014;31(7):483-492.

14.  Alexopoulos GS, et al. Personalised interventions or people with depression and severe COPD.  Br J Psychiatry. 2013;202:235-236.

15.  Hegerl U and Mergl R. Depression and suicidality in COPD: understandable reaction or independent disorders? Eur Respir J. 2014;44(3):734-743.

16.  Panagioti M, et al. Overview of the prevalence, impact, and management of depression and anxiety in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2014;9:1289-1306.