Maurer Janet, Rebbapragada Venkata, Borson Soo, Goldstein Roger, Kunik Mark E, Yohannes Abebaw M, Hanania Nicola A
Chest. 2008 Oct;134(4 Suppl):43S-56S. doi: 10.1378/chest.08-0342.
Approximately 60 million people in the United States live with one of four chronic conditions: heart disease, diabetes, chronic respiratory disease, and major depression. Anxiety and depression are very common comorbidities in COPD and have significant impact on patients, their families, society, and the course of the disease.
We report the proceedings of a multidisciplinary workshop on anxiety and depression in COPD that aimed to shed light on the current understanding of these comorbidities, and outline unanswered questions and areas of future research needs.
Estimates of prevalence of anxiety and depression in COPD vary widely but are generally higher than those reported in some other advanced chronic diseases. Untreated and undetected anxiety and depressive symptoms may increase physical disability, morbidity, and health-care utilization. Several patient, physician, and system barriers contribute to the underdiagnosis of these disorders in patients with COPD. While few published studies demonstrate that these disorders associated with COPD respond well to appropriate pharmacologic and nonpharmacologic therapy, only a small proportion of COPD patients with these disorders receive effective treatment.
Future research is needed to address the impact, early detection, and management of anxiety and depression in COPD.
在美国,约6000万人患有以下四种慢性病之一:心脏病、糖尿病、慢性呼吸道疾病和重度抑郁症。焦虑和抑郁是慢性阻塞性肺疾病(COPD)中非常常见的共病,对患者及其家庭、社会以及疾病进程都有重大影响。
我们报告了一次关于COPD中焦虑和抑郁的多学科研讨会的会议记录,该研讨会旨在阐明目前对这些共病的理解,并概述未解决的问题以及未来研究需求领域。
COPD中焦虑和抑郁的患病率估计差异很大,但总体上高于其他一些晚期慢性病的报告患病率。未经治疗和未被发现的焦虑和抑郁症状可能会增加身体残疾、发病率和医疗保健利用率。患者、医生和系统方面的几个障碍导致COPD患者中这些疾病的诊断不足。虽然很少有已发表的研究表明与COPD相关的这些疾病对适当的药物和非药物治疗反应良好,但只有一小部分患有这些疾病的COPD患者接受了有效治疗。
需要开展未来研究以解决COPD中焦虑和抑郁的影响、早期检测及管理问题。