Treatments for anxiety and depression in patients with chronic obstructive pulmonary disease: A literature review (2025)

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“…The goal of CBT is to reduce depressive symptoms by challenging and reversing these beliefs and attitudes and encouraging people to change their maladaptive preconceptions and behaviours in real life [87]. Although CBT has been shown to reduce symptoms of anxiety and depression in elderly populations [88,89], the evidence in people with COPD is rather limited [90]. A review based on small studies in people with COPD suggests that there is only limited evidence that CBT is effective in reducing symptoms of anxiety and depression when added to exercise and education [91].…”

confidence: 99%

2013

Comprehensive pulmonary rehabilitation is an important component in the clinical management of people with chronic obstructive pulmonary disease (COPD). Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation, there are many other components that should be considered to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. These include approaches designed to: 1) facilitate smoking cessation; 2) optimise pharmacotherapy; 3) assist with early identification and treatment of acute exacerbations; 4) manage acute dyspnoea; 5) increase physical activity; 6) improve body composition; 7) promote mental health; 8) facilitate advance care planning; and 9) establish social support networks. This article will describe these approaches, which may be incorporated within pulmonary rehabilitation, to optimise effective chronic disease self-management. @ERSpublications This paper describes several components of comprehensive pulmonary rehabilitation, other than simply exercise training http://ow.ly/mMNRpPulmonary rehabilitation for chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease (COPD) is characterised by persistent airflow limitation due to chronic inflammation within the airways and lung in response to noxious particles or gases [1]. People with this condition are limited by dyspnoea and have impaired exercise capacity and health-related quality of life [1]. The prevalence of COPD amongst adults aged o40 years is ,10% [2], and increases to 21% in those with a significant smoking history who are visiting their family physician for any reason [3]. The natural course of COPD is punctuated with episodes of acute worsening, known as exacerbations, which contribute

Background: Depression is a highly prevalent co-morbidity in Chronic Obstructive Pulmonary Disease (COPD) which was shown to be associated with a worse course of disease, including reduced quality of life and increased symptoms burden, healthcare use, and even mortality. It has been speculated that systemic inflammation may play a role in the presence of depression. Currently, physical activity is an important lifestyle factor that has the potential to modify inflammatory cytokines and depression, however our understanding of how to use exercise effectively in COPD patients to alleviate depression related systemic inflammation is incomplete and has prompted our interest to identify the type and intensities of effective exercise. Objective: The aim of this study was to measure the changes in depression related systemic inflammation of aerobic exercise training in COPD patients in Jeddah area. Material and methods: Eighty patients with moderate severity of COPD participated in this study and were divided into two groups; the first group received aerobic exercise, whereas the second group received no exercise training for 12 weeks.Results:The mean values of tumor necrosis factor-alpha (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6), C-reactive protein (CRP) and Beck Depression Inventory (BDI) scores were significantly decreased in in group (A) after treatments, but the changes in group (B) were not significant .Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study. Conclusion: Aerobic exercise is an effective treatment policy to improve depression related to systemic inflammation in patients with chronic obstructive pulmonary disease.

Both depression and chronic obstructive pulmonary disease (COPD) are prevalent, severe and often comorbid disorders. There is a risk of undertreatment for depression in patients with COPD as depressive symptoms, including suicidal tendencies, can erroneously be conceptualised as an understandable reaction to COPD and not as signs of an independent depressive disorder. In this context, the comorbidity rates of COPD and depression, the risk of suicidal behaviour in patients with COPD, and the evidence base for pharmaco-and psychotherapy in these patients are reviewed.Because symptoms of depression and COPD overlap it remains unclear how far the prevalence of major depression in COPD exceeds that in the general population. The suicide risk appears to be increased in COPD. Methodological studies providing evidence for the antidepressant efficacy of antidepressants or psychotherapy in patients with COPD are lacking. Recommendations for clinicians on how to separate depression from an understandable reaction to COPD are provided.Given the profound effects of depression on quality of life, life expectancy, COPD prognosis and suicide risk it is important to carefully diagnose and treat depression in patients with COPD according to national guidelines. @ERSpublications Comorbid depression has profound effects on COPD prognosis and should not be seen as understandable reaction to COPD