Effect of Treating Depression on Quality-of-Life and Exercise Tolerance in Severe COPD

Eiser, Noemi M.; Harte, Rosari; Karvounis, Spiros; Phillips, Charles R.; Isaac, Michael T.

doi:10.1081/copd-200057596

Cited by 34 publications

(46 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous small placebo-controlled trials of antidepressant drug therapy in patients with COPD did not demonstrate significant treatment effects on depression or quality of life (table 3) [56,[106][107][108][109][110]. This situation may be explained by several factors.…”

Section: Pharmacological Therapymentioning

confidence: 79%

“…Although respiratory depression is an important potential side-effect of psychotropic medications, the older antidepressants seem to have had little effect on ventilatory drive [105]. No report of such effect is available for the selective serotonin reuptake inhibitors and the newer antidepressants (venlafaxine, duloxetine or mirtazapine).Previous small placebo-controlled trials of antidepressant drug therapy in patients with COPD did not demonstrate significant treatment effects on depression or quality of life (table 3) [56,[106][107][108][109][110]. This situation may be explained by several factors.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

European Respiratory Journal

223

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

Section: Pharmacological Therapymentioning

confidence: 79%

mentioning

confidence: 99%

Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

European Respiratory Journal

223

142

View full text Add to dashboard Cite

show abstract

“…Negative effects of SSRIs on lung function in depressed patients with COPD do not appear to be a major problem. In the case of paroxetine, no significant changes in lung function were found [58]; respiratory symptoms did not worsen and dyspnoea slightly improved [57].…”

Section: Effects Of Selective Serotonin Reuptake Inhibitorsmentioning

confidence: 95%

“…Overall, the available studies did not have the statistical power to detect superiority of SSRI over placebo [55][56][57][58]. In addition, the drop-out rates in these trials were high (21-50%), and a variety of depression rating scales was used (table 4) [10], Frustration with multiple medications and the fear of side-effects have been discussed as the reasons for high dropout rates for depressed COPD patients reported in these antidepressant trials [10].…”

Section: Effects Of Selective Serotonin Reuptake Inhibitorsmentioning

confidence: 99%

Depression and suicidality in COPD: understandable reaction or independent disorders?

Hegerl

Mergl

2014

European Respiratory Journal

View full text Add to dashboard Cite

Both depression and chronic obstructive pulmonary disease (COPD) are prevalent, severe and often comorbid disorders. There is a risk of undertreatment for depression in patients with COPD as depressive symptoms, including suicidal tendencies, can erroneously be conceptualised as an understandable reaction to COPD and not as signs of an independent depressive disorder. In this context, the comorbidity rates of COPD and depression, the risk of suicidal behaviour in patients with COPD, and the evidence base for pharmaco-and psychotherapy in these patients are reviewed.Because symptoms of depression and COPD overlap it remains unclear how far the prevalence of major depression in COPD exceeds that in the general population. The suicide risk appears to be increased in COPD. Methodological studies providing evidence for the antidepressant efficacy of antidepressants or psychotherapy in patients with COPD are lacking. Recommendations for clinicians on how to separate depression from an understandable reaction to COPD are provided.Given the profound effects of depression on quality of life, life expectancy, COPD prognosis and suicide risk it is important to carefully diagnose and treat depression in patients with COPD according to national guidelines. @ERSpublications Comorbid depression has profound effects on COPD prognosis and should not be seen as understandable reaction to COPD

show abstract

“…Meanwhile, in view of complex disease pathophysiology, it has been shown that there are various potential factors that could affect the physical activity and/or quality of life in patients with COPD. These factors include skeletal muscle abnormalities (24), concomitant depression/anxiety (25,26), other co-morbidities and/or exacerbations (27). In our study significant correlations (P<0.05) were found between six-minute walk distance and total SGRQ-score (r=−0.50) and its components including symptoms, activity and impacts (r=−0.36, −0.52 and −0.43 respectively).…”

Section: Discussionmentioning

confidence: 99%

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

Mirdamadi¹,

Rahimi²,

Safavi³

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: The precise head to head relationships between Cardio-pulmonary exercise testing (CPET) parameters and patients' daily symptoms/activities and the disease social/emotional impact are less well defined. In this study, the correlation of COPD daily symptoms and quality of life [assessed by St. George's Respiratory Questionnaire (SGRQ)] and COPD severity index (BODE-index) with CPET parameters were investigated. Methods: Symptom-limited CPET was performed in 37 consecutive COPD (GOLD I-III) subjects during non-exacerbation phase. The SGRQ was also completed by each patient. Results: SGRQ-score correlated negatively with FEV1 (r=−0.49, P<0.01), predicted maximal workrate (%WR-max) (r=−0.44, P<0.01), V'O 2 /WR (r=−0.52, P<0.01) and breathing reserve (r=−0.50, P<0.01). However it did not correlate with Peak-V'O 2 % predicted (r=−0.27, P=0.10). In 20 (54.1%) subjects in which leg fatigue was the main cause for stopping the test, Peak-V'O 2 , %WR-max, HR-Reserve and Breathing reserve were higher (P=0.04, <0.01, 0.04 and <0.01 respectively) than the others. There was also a significant correlation between BODE-index and ∆VO 2 /∆WR (r=−0.64, P<0.001) and breathing-reserve (r=−0.38, P=0.018). Conclusions: The observed relationships between CPET parameter and daily subjective complaints in COPD were not strong. Those who discontinued the CPET because of leg fatigue were in the earlier stages of COPD. Significant negative correlation between ∆VO 2 /∆WR and BODE-index suggests that along with COPD progression, regardless of negative past history, other comorbidities such as cardiac/musculoskeletal problems should be sought. Although more difficult to use than other tools such as COPD Assessment Test (CAT) or COPD Clinical Questionnaire (CCQ) during routine daily practice (6), the St. George's Respiratory Questionnaire (SGRQ) is one of the most widely used self-complete measures in research for assessing patients' symptoms, activities and quality of life (7,8). Along with this subjective measurement, functional capacity in COPD could be measured by objective tools such as cardio-pulmonary exercise testing (CPET) or 6-min walk distance (6MWD) (9-11). Considering the fact that at rest physiologic variable such as pulmonary diffusing capacity for carbon monoxide (DLCO), body mass index (BMI) or even forced expiratory volume in one second (FEV1) could not solely predict exercise intolerance, CPET has been proposed as the gold standard for evaluating the exercise intolerance in patients with pulmonary diseases, including COPD (12). But the precise head to head comparisons of CPET variable with patients' daily symptoms/activities and the disease social/ emotional impact are less well defined. In one study among 129 COPD subjects with GOLD stage II and III, there was at best a weak correlation between Peak-V'O 2 (maximum oxygen uptake) % predicted and some sub-domains of health status (13). While in another study Peak-V'O 2 was to some extent a predictor of physical function (r 2 increased by 0.109) and health-related ...

show abstract

Effect of Treating Depression on Quality-of-Life and Exercise Tolerance in Severe COPD

Cited by 34 publications

References 16 publications

Anxiety and depression in end-stage COPD

Anxiety and depression in end-stage COPD

Depression and suicidality in COPD: understandable reaction or independent disorders?

Correlation of cardiopulmonary exercise testing parameters with quality of life in stable COPD patients

Contact Info

Product

Resources

About