Buican Iulian-Laurențiu, Buican-Chirea Alina-Cătălina, Mușat Mădălina Iuliana, Streba Costin Teodor
U.M.F. Doctoral School Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Leamna Pulmonology Hospital, 207129 Leamna, Romania.
Healthcare (Basel). 2025 Sep 18;13(18):2344. doi: 10.3390/healthcare13182344.
: Chronic Obstructive Pulmonary Disease (COPD) is a prevalent, progressive condition often associated with psychiatric comorbidities such as depression and anxiety, which negatively affect disease progression, treatment adherence, and quality of life. : A narrative review was conducted by searching PubMed and Google Scholar for English-language publications from January 2015 to July 2025. This type of review was selected to allow for a broad and integrative analysis of the current evidence on the association between COPD and psychiatric comorbidities, particularly depression and anxiety. To increase comprehensiveness, the reference lists of the included articles and systematic reviews were manually screened, and data extraction and evaluation were conducted independently by two reviewers. : Reported prevalence rates vary widely in COPD patients with depression ranging from 10 to 57% and anxiety from 7 to 50%, largely due to differences in patient populations, diagnostic tools, and disease severity. Identified risk factors include female gender, social isolation, smoking, low BMI, comorbidities, and systemic inflammation. These comorbidities are associated with increased exacerbations, higher hospitalization rates, and poorer clinical outcomes. While inhaled therapies may have limited impact on psychiatric symptoms, antidepressants must be used cautiously. Non-pharmacological interventions, including pulmonary rehabilitation, cognitive-behavioral therapy, physical activity, and social support, demonstrate clear benefits. : Effective management of COPD requires integrated approaches that address both pulmonary and psychiatric components. Tailored interventions can improve clinical outcomes and quality of life. This review explores the bidirectional relationship between COPD and psychiatric disorders, aiming to highlight risk factors, diagnostic tools, and both pharmacological and non-pharmacological treatment strategies.
慢性阻塞性肺疾病（COPD）是一种常见的、进行性疾病，常与抑郁症和焦虑症等精神疾病共病，这些共病会对疾病进展、治疗依从性和生活质量产生负面影响。
通过检索PubMed和谷歌学术，对2015年1月至2025年7月期间的英文出版物进行了叙述性综述。选择这种类型的综述是为了对目前关于COPD与精神疾病共病，特别是抑郁症和焦虑症之间关联的证据进行广泛和综合的分析。为了提高全面性，对纳入文章和系统评价的参考文献列表进行了人工筛选，两位审稿人独立进行数据提取和评估。
据报道，COPD合并抑郁症患者的患病率差异很大，从10%到57%不等，合并焦虑症的患病率从7%到50%不等，这主要是由于患者群体、诊断工具和疾病严重程度的差异。已确定的风险因素包括女性、社会隔离、吸烟、低体重指数、共病和全身炎症。这些共病与病情加重、住院率升高和临床结局较差有关。虽然吸入疗法对精神症状的影响可能有限，但使用抗抑郁药时必须谨慎。包括肺康复、认知行为疗法、体育活动和社会支持在内的非药物干预措施显示出明显的益处。
COPD的有效管理需要综合方法，同时解决肺部和精神方面的问题。量身定制的干预措施可以改善临床结局和生活质量。本综述探讨了COPD与精神障碍之间的双向关系，旨在突出风险因素、诊断工具以及药物和非药物治疗策略。
