The Impact of Anxiety and Depression in Chronic Obstructive Pulmonary Disease

HIGHLIGHTS: Chronic obstructive pulmonary disease (COPD) patients experience a higher level of psychological distress than the general population, including anxiety and/or depression. This article reviews the pathophysiology, clinical features, impact of mental health disorders in COPD patients. It dives into the current screening, diagnosis, and management of this population. What are the main findings? COPD patients with comorbid anxiety or depression experience more acute exacerbations, incidences of rehospitalization, and carry a higher risk of mortality than COPD patients without these comorbidities. COPD patients benefit from non-pharmacological and pharmacological intervention based on severity of depression. What is the implication of the main findings? Ongoing investigation and research are necessary to ensure appropriate screening, diagnosis, and management of COPD patient with anxiety and/or depression. Adequate treatment of COPD patients with comorbid mental health conditions can decrease the burden on the healthcare system by improving symptomatology and rehospitalizations. ABSTRACT: Patients with COPD (chronic obstructive pulmonary disease) are at a higher risk of comorbid conditions such as anxiety and/or depression, which in turn increase their symptom burden and rehospitalizations compared to the general population. It is important to investigate the pathophysiology and clinical implications of mental health on patients with COPD. This review article finds that COPD patients with anxiety and/or depression have a higher rehospitalization incidence. It reviews the current screening and diagnosis methods available. There are pharmacological and non-pharmacologic interventions available for treatment of COPD patients with depression based on severity. COPD patients with mild depression benefit from pulmonary rehabilitation and cognitive behavioral therapy, whereas patients with severe or persistent depression can be treated with pharmacologic interventions.