A Practical Screening Tool for Anxiety and Depression in Patients With Chronic Breathing Disorders

Kunik, Mark E.; Azzam, Pierre N.; Souchek, Julianne; Cully, Jeffrey A.; Wray, Nelda P.; Krishnan, Laura L.; Nelson, Harlan A.; Stanley, Melinda A.

doi:10.1176/appi.psy.48.1.16

Cited by 50 publications

(38 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a study of Veterans with breathing disorders (M 5 63.3, SD 5 11.8), 82.8% screened positive for depression and/or anxiety using a brief patient telephone questionnaire. [124] A subset of this sample completed the BAI and 82.8% of this subset reported clinically significant symptoms of anxiety (i.e., BAI score of 16 or higher). One study found that asthma was associated with anxiety disorders (sample aged 60 and older), but that this association did not attain statistical significance.…”

Section: Comorbidity and Differential Diagnosismentioning

confidence: 99%

Anxiety disorders in older adults: a comprehensive review

Wolitzky-Taylor¹,

Castriotta²,

Lenze³

et al. 2010

Depress. Anxiety

Self Cite

547

398

View full text Add to dashboard Cite

This review aims to address issues unique to older adults with anxiety disorders in order to inform potential changes in the DSM-V. Prevalence and symptom expression of anxiety disorders in late life, as well as risk factors, comorbidity, cognitive decline, age of onset, and treatment efficacy for older adults are reviewed. Overall, the current literature suggests: (a) anxiety disorders are common among older age individuals, but less common than in younger adults; (b) overlap exists between anxiety symptoms of younger and older adults, although there are some differences as well as limitations to the assessment of symptoms among older adults; (c) anxiety disorders are highly comorbid with depression in older adults; (d) anxiety disorders are highly comorbid with a number of medical illnesses; (e) associations between cognitive decline and anxiety have been observed; (f) late age of onset is infrequent; and (g) both pharmacotherapy and CBT have demonstrated efficacy for older adults with anxiety. The implications of these findings are discussed and recommendations for the DSM-V are provided, including extending the text section on age-specific features of anxiety disorders in late life and providing information about the complexities of diagnosing anxiety disorders in older adults. Depression and Anxiety 27:190-211, 2010.

show abstract

Section: Comorbidity and Differential Diagnosismentioning

confidence: 99%

Anxiety disorders in older adults: a comprehensive review

Wolitzky-Taylor¹,

Castriotta²,

Lenze³

et al. 2010

Depress. Anxiety

Self Cite

547

398

View full text Add to dashboard Cite

show abstract

“…Other instruments have been evaluated since the publication of the above review [48,99], including one developed specifically for use in COPD [100]. Unfortunately, there is very limited information regarding the use of routinely administered screening questionnaires for depression, or whether their use impacts on the detection, management or outcome of depressive symptoms [101].…”

Section: Screening and Diagnosismentioning

confidence: 99%

Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

European Respiratory Journal

227

142

View full text Add to dashboard Cite

Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), estimates of their prevalence vary considerably. This probably reflects the variety of scales and methods used to measure such symptoms. Regardless of whether anxiety and depression are considered separately or as a single construct, their impact on COPD patients is important.A heightened experience of dyspnoea is likely to be a contributing factor to anxiety. Feelings of depression may be precipitated by the loss and grief associated with the disability of COPD. Smoking has been associated with nicotine addiction, and the factors that contribute to smoking may also predispose to anxiety and depressive disorders.Randomised controlled trials indicate that exercise training and carefully selected pharmacological therapy are often effective in ameliorating anxiety and depression. Most medical illnesses are influenced by the psychological responses and coping mechanisms that patients use. However, anxiety and depression are associated with dyspnoea, fatigue and altered sleep, all of which also occur in COPD.An understanding of the psychological history and coping mechanisms of patients and the role of anxiety and depressive reactions to illness may enable clinicians to reduce these symptoms and improve quality of life among patients with chronic obstructive pulmonary disease.KEYWORDS: Anxiety, chronic obstructive pulmonary disease, depression C hronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction that is not fully reversible [1]. In addition to the primary pulmonary pathology, the impact of secondary skeletal muscle dysfunction on exercise capacity and survival is well established [2,3]. Psychological impairments, ranging from feelings of depression and anxiety to full diagnostic mental disorders, although prevalent in this population, have received less interest. As COPD is incurable, therapeutic interventions aim to optimise function and slow disease progression [4]. Attention has focused predominantly on the effectiveness of strategies such as smoking cessation [5], longterm oxygen therapy (LTOT) [6,7], influenza vaccines [8], respiratory-specific pharmacological management [9], surgical options [10], conditioning of the peripheral muscles with graduated exercise training [11] and chronic disease selfmanagement strategies [12].Despite the prevalence of depression and anxiety and their impact on the morbidity associated with COPD, these psychological consequences of the disease are rarely addressed, at least in the respiratory medicine community. The purpose of the present review is to raise awareness among pulmonologists, general practitioners and allied health professionals to the secondary psychological impairment associated with COPD. Although anxiety and depression often coexist, they represent separate constructs [13]. Broader reviews of the psychological characteristics of patients with COPD are available [14]. ANXIETY Classification and diagnostic cr...

show abstract

“…Table 1 lists the criteria for diagnosing major depressive disorder as defined by the Diagnostic and Statistical Manual for Mental Disorders-5 th Edition (11). A recent study has determined that the following two simple questions from the Primary care Evaluation of Mental Disorders (PRIME-MD) are able to adequately screen those (94.6% sensitivity) who need further depression evaluation (3,(12)(13) In the past two weeks, have you felt bothered a lot by: -little interest or pleasure in doing things? -feeling down, depressed, or hopeless?…”

Section: Screening For Depression In the Pulmonary Rehabilitation Promentioning

confidence: 99%

“…The disturbance is not better explained by another mental disorder Anxiety and worry are associated with three or more of the following, with at least three or more of the symptoms being present for more days than not for the past six months: from the PRIME-MD to screen for depression also successfully used the following three questions to adequately screen for anxiety (4, 12-13) The first two questions are phrased similarly to the depression screening question, but the third question attempts to capture more severe episodes such as panic attacks (4,12) In the past month, have you felt bothered a lot by: Nerves, or feeling anxious or being on edge? Worrying about a lot of different things?…”

Section: Screening For Panic Disorder and Generalized Anxiety Disordermentioning

confidence: 99%

Psychosocial Assessment and Intervention in Patients Undergoing Pulmonary Rehabilitation

Barker¹

2015

Toraks Cer Bult

View full text Add to dashboard Cite

ÖzetPsikososyal etkenler, kronik obstrüktif akciğer hastalığı olanlarda pulmoner rehabilitasyon sürecini anlamlı şekilde etkilerler. Sonuçlar, ilk olarak rehabilitasyon süreci önünde-ki psikolojik, algısal ve sosyal engelleri berlileyerek, ikinci olarak da uygun girişimler veya hastayı uygun kişilere yön-lendirerek, en iyi seviyeye getirilebilir. Toplumun kullanımına uygun, depresyon, aknsiyete ve algılama bozukluğunda yeri olan Center for Epidemiological Studies-Depression (CES-D), Generalized Anxiety Disorder-7 item test (GAD-7) ve Montreal Cognitive Assessment (MoCA) gibi testlerin hepsi geçerli ve süreci değerlendirmekte güvenilir araç-lardır. Depresyon, anksiyete ve algılama bozukluğunun hepsi de hastanın rehabilitasyon programına katılımını etkilerken, sigara içilmesi rehabilitasyon sürecine zarar verir. Psikososyal bir engel olmamakla birlikte sigara kullanımı, hastanın daha iyi sonuç elde edebilmesi ve hastalığın nüks riskini düşürmesi için değiştirmesi gereken bir alışkanlıktır. Etkili motive edici konuşmalar ve sigara bırakma terapileri, hastanın bu zararlı davranışını bırakmasında gereklidir. Psikolog ve aile danışmanı yardımıyla pulmoner rehabilitasyonun başlangıcınde bu engellerin ortaya konması ve sorumlu tedavi sağlayıcıların yardımının kaydedilmesi, genel tıbbi uyumluluğu, fiziksel işlevleri ve yaşam kalitesini iyileştirebilir. Anahtar kelimeler: Depresyon, anksiyete, pulmoner rehabilitasyon, KOAH, sigarayı bırakma AbstractPsychosocial factors significantly affect the pulmonary rehabilitation process in patients dealing with chronic obstructive pulmonary diseases. Their outcomes can be optimized by the evaluation of the psychological, cognitive, or social barriers to the rehabilitation process, followed by appropriate interventions and referral to the suitable practitioners. Publicly available screening tests for depression, anxiety, and cognitive decline, such as the Center for Epidemiological Studies-Depression (CES-D), Generalized Anxiety Disorder-7 item test (GAD-7), and Montreal Cognitive Assessment (MoCA), respectively, are all valid reliable tools for assessing and measuring progress. Depression, anxiety, and cognitive decline all affect patients' adherence to rehabilitation programs, whereas smoking is counterproductive to the rehabilitation process. Smoking, while not being a specific psychological disorder, is a lifestyle habit requiring patients' willingness to change, to further optimize outcomes and decrease the risk of disease exacerbation. Effective motivational conversations and smoking cessation therapies are necessary for improving patients' willingness to change their detrimental behavior. Addressing these psychosocial barriers in the setting of pulmonary rehabilitation via access to psychologists, family counselors, as well as help from responsible caregivers can improve the patients' overall medical compliance, physical function, and quality of life.

show abstract

A Practical Screening Tool for Anxiety and Depression in Patients With Chronic Breathing Disorders

Cited by 50 publications

References 25 publications

Anxiety disorders in older adults: a comprehensive review

Anxiety disorders in older adults: a comprehensive review

Anxiety and depression in end-stage COPD

Psychosocial Assessment and Intervention in Patients Undergoing Pulmonary Rehabilitation

Contact Info

Product

Resources

About