Brenes Gretchen A
Wake Forest University School of Medicine, Department of Psychiatry and Behavioral Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Psychosom Med. 2003 Nov-Dec;65(6):963-70. doi: 10.1097/01.psy.0000097339.75789.81.
This article reviews the prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease (COPD) as well as the impact of comorbid anxiety on quality of life in patients with COPD. Published studies on three types of treatments for anxiety are then reviewed: psychopharmacology, psychotherapy, and pulmonary rehabilitation programs.
A PubMed search was conducted of the literature from 1966 through 2002 using the keywords anxiety, chronic obstructive pulmonary disease, respiratory diseases, obstructive lung diseases, and pulmonary rehabilitation. Any articles that discussed the prevalence of anxiety symptoms or anxiety disorders among patients with COPD, the impact of anxiety on patients with COPD, or the treatment of anxiety in COPD patients were included in this review.
Anxiety disorders, especially generalized anxiety disorder (GAD) and panic disorder, occur at a higher rate in patients with COPD compared with the general population. Not surprisingly, anxiety has a significant and negative impact on quality of life of COPD patients. Nonetheless, few studies have examined pharmacological, psychotherapeutic, or pulmonary rehabilitation treatments for anxiety disorders in the context of COPD. Trials of nortriptyline, buspirone, and sertraline have been found to reduce symptoms of anxiety. Similarly, cognitive-behavioral programs that focus on relaxation and changes in thinking also produced declines in anxious symptoms. Finally, multicomponent pulmonary rehabilitation programs can also result in reductions in anxious symptoms.
Studies examining the treatment of anxiety disorders in patients with COPD are promising, yet their efficacy needs to be established. The long-term effects of treatment of anxiety disorders on quality of life of COPD patients have yet to be explored.
本文综述慢性阻塞性肺疾病（COPD）患者焦虑症的患病率，以及共病焦虑对COPD患者生活质量的影响。随后回顾已发表的关于三种焦虑症治疗方法的研究：心理药理学、心理治疗和肺康复计划。
使用关键词焦虑、慢性阻塞性肺疾病、呼吸系统疾病、阻塞性肺疾病和肺康复，对1966年至2002年的文献进行PubMed检索。任何讨论COPD患者焦虑症状或焦虑症患病率、焦虑对COPD患者的影响或COPD患者焦虑症治疗的文章均纳入本综述。
与普通人群相比，COPD患者焦虑症的发生率更高，尤其是广泛性焦虑症（GAD）和惊恐障碍。不出所料，焦虑对COPD患者的生活质量有显著负面影响。尽管如此，很少有研究在COPD背景下研究焦虑症的药物、心理治疗或肺康复治疗。已发现去甲替林、丁螺环酮和舍曲林的试验可减轻焦虑症状。同样，专注于放松和思维改变的认知行为计划也能使焦虑症状减轻。最后，多组分肺康复计划也可导致焦虑症状减轻。
研究COPD患者焦虑症治疗的前景广阔，但其疗效有待确定。焦虑症治疗对COPD患者生活质量的长期影响尚未得到探索。
