Life quality, anxiety and depression in patients with сhronic obstructive pulmonary disease (literature review)

Abstract

Chronic obstructive pulmonary disease (COPD) is an irreversible disease, the main symptoms of which are shortness of breath and cough. With progression, these symptoms worsen the patients’ life quality, limit their physical activity and lead to psychological problems. COPD is the fourth most common disease in the world and one of the leading causes of death. A review of epidemiological studies shows that depression occurs in patients with COPD in 6—80 % of cases, with an average of about 40 %. Also, these patients often have anxiety disorders in 10 to 55 % of cases.158 literature sources in Pubmed database on request COPD AND depression AND anxiety for last 10 years were included to the study and 44 of them were selected for further detailed study.According to the analysis of literature sources, possible relationships between COPD, life quality, anxiety and depressive disorders were found, approaches to their detection, monitoring and treatment were described, as well as the importance of controlling COPD symptoms to improve the patients’ life quality and reduce the manifestations of psychological and mental disorders. Evidence has been found indicating that an increase in physical activity when COPD symptoms are controlled changes the state of functioning of central monoamines, increases the regulation of the hypothalamic­-pituitary-­adrenal system, increases the release of endogenous opioids and decreases the severity of systemic inflammation, which reduces the manifestations of anxiety and depression.Due to the bidirectional relationship of patients’ life quality, depression and anxiety, and COPD, the most effective is an integrated approach that improves the patient’s condition through the impact on both physical and psychological factors. However, there is still a need for randomized trials to definitively study the benefits of psychological, pharmacological, and combined treatments for depression and anxiety disorders in COPD.