Highlights
- •The point prevalence of depression in patients with chronic obstructive pulmonary disease is estimated to range from 8% to 81% and in patients with asthma from 13% to 32%.
- •Depression in these contexts is often under-recognized and inadequately treated.
- •The causes of depression in patients with chronic obstructive pulmonary disease and asthma are multifactorial and include physical, physiological and behavioural factors.
- •There is some evidence to suggest that pulmonary rehabilitation and cognitive behavioural therapy are beneficial in reducing depression in patients with chronic obstructive pulmonary disease and asthma.
- •The efficacy of antidepressant therapy for treatment of depression in patients with chronic obstructive pulmonary disease and asthma is inconclusive.
Abstract
Respiratory diseases are common in older people. However, the impact of comorbid depression
in older patients with chronic obstructive pulmonary disease (COPD) and asthma has
not been fully explored. This narrative review examines the impact of comorbid depression
and its management in COPD and asthma in older adults. The causes of depression in
patients with COPD and asthma are multifactorial and include physical, physiological
and behavioural factors. Depression is associated with hospital readmission in older
adults with asthma and COPD. We focus on the most current literature that has examined
the efficacy of pulmonary rehabilitation (PR), cognitive behavioural therapy (CBT)
and antidepressant drug therapy for patients with depression in the context of COPD
and asthma. Our findings indicate that PR and CBT are beneficial in improving depressive
symptoms and quality of life in short-term intervention studies. However, the long-term
efficacy of CBT and PR is unknown. To date, the efficacy of antidepressant drug therapy
for depression in patients with COPD and asthma is inconclusive. In addition, there
has been no clear evidence that antidepressants can induce remission of depression
or ameliorate dyspnoea or physiological indices of COPD. Factors that contribute to
‘inadequate’ assessment and treatment of depression in patients with COPD and asthma
may include misconception of the disease by patients and their caregivers and stigma
attached to depression. Thus, well-controlled randomized controlled trials are needed.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Projections of global mortality and burden of disease from 2002 to 2030.PLoS Med. 2007; 3: e442
- Depression chronic diseases, and decrements in health: results from the World Health Surveys.Lancet. 2007; 370: 851-858
World Health Organization Report (2008). http://www.who.int/respiratory/copd/World_Health_Statistics_2008/en/index.html.
U.S. Department of Health and Human Services. National Institutes of Health. National Heart Lung and Blood Institute. Morbidity and Mortality: 2009 Chart book on Cardiovascular, Lung and Blood Diseases.
- The global burden of asthma executive summary of GINA dissemination report.Allergy. 2004; 59: 469-478
- Incremental direct expenditure of treating asthma in the United States.J. Asthma. 2009; 46: 73-80
- ACCP workshop panel on anxiety and depression in COPD. Anxiety and depression in COPD: current understanding unanswered questions, and research needs.Chest. 2008; 134: 43S-56S
- Close correlation between anxiety depression, and asthma control.Respir. Med. 2010; 104: 22-28
- Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles.Int. J. Geriatr. Psychiatry. 2010; 25: 1209-1221
- Depression and its associated factors in older Indians: a study based on study of global aging and adult health (SAGE)-2007.J. Aging Health. 2015; 27: 622-649
- Asthma and depressive and anxiey disorders among young persons in the community.Psychol. Med. 2004; 34: 1465-1474
- Mood disorders in patients with chronic obstrctuce pulmonary disease.Rev. Clin. Gerontol. 2001; 22: 55-65
- What’s worse for asthma control and quality of life: depressive disorders, anxiety disorders, or both.Chest. 2006; 130: 1039-1047
- A feasability study of antidepressant drug therapy in elderly depressed patients with chronic obstructive pulmonary disease.Int. J. Geriatr. Psychiatry. 2001; 16: 451-454
- Bidirectional associations between clinically relevant depression or anxiety and COPD: a systematic review and meta-analysis.Chest. 2013; 144: 766-777
- Comprehensive meta-analysis of excess mortality in depression in the general community versus patients with specific illnesses.Am. J. Psychiatry. 2014; 171: 453-462
- Prevalence of anxiety symptoms with astma: a meta-analysis and meta-regression.Pediatr. Allergy Immunol. 2012; 23: 707-715
- Long-term course of depression trajectories in patients with COPD: a 3-year follow-up analysis of the evaluation of COPD longitudinally to identify predictive surrogate endpoints cohort.Chest. 2016; 149: 916-926
- Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD.Respir. Res. 2011; 12: 3
- The type 1 TNF receptor and its associated adapter protein, FAN, are required for TNFalpha-induced sickness behavior.Psychopharmacology (Berl.). 2009; 201: 549-555
- Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire.Int. J. Geriatr. Psychiatry. 2000; 15: 1090-1096
- Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study: a prospective population-based analysis.Lancet Respir. Med. 2016; https://doi.org/10.1016/s2213-2600(16)00098-9
- Frequency and characteristics of different clinical phenotypes of chronic obstructive pulmonary disease.Int. J. Tuberc. Lung Dis. 2015; 19: 992-998
- Depression is associated with readmission for acute exacerbation of chronic obstructive pulmonary disease.Ann. Am. Thorac. Soc. 2016; 13: 197-203
- Age-related Differences in the rate timing, and diagnosis of 30-day readmissions in hospitalized adults with asthma exacerbation.Chest. 2016; 149: 1021-1029
- Comprehensive pulmonary rehabilitation for anxiety and depression in adults with chronic obstructive pulmonary disease: systematic review and meta-analysis.J. Psychsom. Res. 2007; 63: 551-565
- The impact of anxiety and depression on outcomes of pulmonary rehabilitation in patients with COPD.Chest. 2011; 140: 730-736
- The responsiveness of the anxiety inventory for respiratory disease (AIR) scale following pulmonary rehabilitation.Chest. 2016; 150: 188-195https://doi.org/10.1016/j.chest.2016.02.658
- Depression in Adults: The Treatment and Management of Depression in Adults.2016 (https://www.nice.org.uk/guidance/CG91 (accessed 27.06.16))
- Outcomes of depressed patients undergoing inpatient pulmonary rehabilitation.Am. J. Geriatr. Psychiatry. 2006; 14: 466-475
- A review of the effectiveness of psychological interventions used for anxiety and depression in chronic obstructive pulmonary disease.BMJ Open Respir. Res. 2014; 1: e000042
- Efficacy of psychosocial interventions on psychological and physical health outcomes in chronic obstructive pulmonary disease: a systematic review and meta-analysis.Psychother. Psychosom. 2015; 84: 37-50
- Cognitive behavioural intervention for adults with anxiety complications of asthma: prospective randomized trial.Respir. Med. 2012; 106: 802-811
- Pharmacological treatment of depression in older patients with chronic obstructive pulmonary disease: impact on the course of the disease and health outcomes.Drugs Aging. 2014; 31: 483-492
- Bupropion in the treatment of outpatients with asthma and major depressive disorder.Int. J. Psychiatry Med. 2007; 37: 23-28
- General practitioners views and experiences in managing depression in patients with chronic obstructive pulmonary disease.Expert Rev. Respir. Med. 2012; 6: 589-595
- Collaborative care for depression in patients with chronic illnesses.N. Engl. J. Med. 2010; 363: 2611-2620
- Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management.Arch. Intern. Med. 2007; 167: 551-561
- Impact of disease management programs on healthcare expenditures for patients with diabetes, depression, heart failure or chronic obstructive pulmonary disease: a systematic review of the literature.Health Policy. 2011; 101: 105-121
Article info
Publication history
Published online: July 08, 2016
Accepted:
July 7,
2016
Received:
July 1,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
