COPD & PSYCHIATRIC DISORDER
Dr. Sanjay Kochar
COPD is a chronic progressive condition characterized by slowly progressive irreversible bronchial obstruction & a fluctuating symptom complex of recurrent productive cough & dyspnoea. Due to irreversible nature of COPD, the aim of treatment in COPD is not to cure but to reduce symptoms, increase functioning & improve the patients quality of life. As smoking is the risk factor for COPD the best way to stop getting more lung damage is to quit smoking.
It has been reported that psychiatric disorders are more prevalent in COPD Patients than general population but due to different diagnostic instruments they reported different prevalence rates. COPD & Psychiatric disorders have bidirectional association. The higher rate of smoking is seen in patients with depression and anxiety could lead to the higher prevalence rate of COPD in depression patients. COPD itself significantly affects mental health because COPD causes a lot of changes in body. Breathlessness weight loss, sleeping & eating problems & depletion of energy are few examples. Many of these changes can lead to feeling of loss & negativity because you can no longer do the things you used to do & can cause anxiety & depression. Anxiety & depression can actually exacerbate physical symptoms. It may cause patients to turn to alcohol, cigarette or other unhealthy habits to cope. Thats why its important to recognize the symptoms of psychiatric illness i.e. – feeling irritable or angry with others, feeling sad & hopeless, lethargy & lack of motivation, lack of interest, trouble in falling asleep or staying asleep, increased or decreased appetite.
Psychiatric co morbidity in COPD patients particularly anxiety & depression have been linked to increased mortality, decrees functional status & decreases quality of life in these patients. This coexisting psychiatric disorder should be diagnosed & treated as soon as possible to improve patient’s outcome but unfortunately they often remains undiagnosed without psychiatric assessment.
Professor & Head Respiratory Division,
Department of Medicine,
S.P. Medical College, Bikaner-334001