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Depression, anxiety and cognitive impairment are common among persons with COPD, and psychological symptoms are associated with worse outcomes.
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Psychological symptoms may affect adherence to pulmonary rehabilitation programs, and screening for these symptoms should be considered.
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Pulmonary rehabilitation may improve depression and anxiety symptoms although the effect on cognitive function is not as clear.
Anxiety, Depression, and Cognitive Impairment in Patients with Chronic Respiratory Disease
Section snippets
Key points
Prevalence of depression
Depression and anxiety are the most common psychosocial concerns seen in chronic pulmonary patients enrolled in pulmonary rehabilitation.7 Estimates of the prevalence of depression range from 10% to close to 80% (depending on the instrument and method used to screen), although the prevalence is most commonly reported as between 25% and 50%.8, 9, 10 The higher percentages likely reflect the presence of symptom burden rather than clinically defined disease. Also, the prevalence of depression may
Does depression affect participation and the likelihood of benefitting from pulmonary rehabilitation?
Depression may affect patients’ ability to engage in self-care behaviors,32 and in diabetes and heart disease depression, it is associated with worse adherence to medications used to treat the disease.33, 34 In COPD, it is not known whether depression affects adherence to medications, but there is increasing evidence that depression affects whether patients initiate or complete a pulmonary rehabilitation program. For example, an analysis of participants in a large randomized controlled trial of
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Pilot RCT of a telehealth intervention to reduce symptoms of depression and anxiety in adults with cystic fibrosis
2022, Journal of Cystic FibrosisCitation Excerpt :Depression and anxiety are 2,3 times higher in adults with cystic fibrosis (awCF) than community samples [1]. Elevated psychological distress has been associated with worse health outcomes (e.g., lower lung functioning, lower BMI, more pulmonary exacerbations, listed for transplant) [1], maladaptive coping [2], worse adherence [3,4], poorer HRQoL [1], and earlier mortality [5]. International mental health guidelines for CF [6] recommend a brief, supportive intervention for awCF reporting symptoms of depression or anxiety in the mild range, and evidence-based treatment for those in the moderate to severe range.
Cognitive Impairment in Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: A Systematic Review and Meta-analysis of Observational Studies
2017, Journal of the American Medical Directors AssociationCitation Excerpt :It could be comorbidities that influence impairment in executive tasks requiring memory and attention allocation, and these factors could potentially explain the relationship between cognitive impairment in patients with COPD and CHF. Furthermore, cognitive impairment may contribute to increased behavioral disturbances (eg, panic and anxiety/depression) and poor adherence to rehabilitation and drug therapy, which are much higher in COPD and CHF55 than in patients with other conditions.56,57 In addition, the increased risk for cognitive impairment in patients with COPD and CHF shown in our data may be partially explained by the potential role of inflammation and vascular disease in pathogenesis of MCI and cognitive impairment.
Respiration pattern variability and related default mode network connectivity are altered in remitted depression
2018, Psychological MedicineA Novel ECG-Derived Respiration Method Combining Frequency-Domain Feature and Interacting Multiple Model Smoother
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VA Statement: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government. This material is the result of work supported by resources from the VA Puget Sound Health Care System, Seattle, Washington.