Anxiety and post-traumatic stress disorders in patients with chronic respiratory diseases

Purpose of review This brief critical review evaluates recent research on the impact of anxiety disorders and post-traumatic stress disorders (PTSD) on patients with chronic obstructive pulmonary disease (COPD) and asthma. In these patients, untreated anxiety and PTSD exacerbate acute symptoms, increase disability and impair quality of life. Therefore, effective interventions are also reviewed. Recent findings Anxiety disorders and PTSD are prevalent in COPD and asthma, worsen symptoms in acute exacerbations, and increase morbidity and healthcare utilization. Pulmonary rehabilitation (PR), cognitive behavioural therapy and pharmacological therapy are each effective in COPD patients with anxiety or PTSD. However, very little work examined therapy for combined anxiety and PTSD in patients with either COPD or asthma. Summary Despite the high prevalence of anxiety disorder or PTSD in patients with chronic respiratory diseases, a paucity of literature remains demonstrating the efficacy of pharmacological therapies for these conditions. This review highlights the promising benefits of PR on anxiety, but prospective trials are needed to demonstrate the efficacy of interventions with PTSD alone, or with concomitant anxiety.

[1]  I. Farver-Vestergaard,et al.  COPD-Related Anxiety: A Systematic Review of Patient Perspectives , 2023, International journal of chronic obstructive pulmonary disease.

[2]  D. Brooks,et al.  The Relationship between Physical Activity, Depression and Anxiety in People with COPD: A Systematic Review and Meta-analyses. , 2023, COPD.

[3]  J. Fonseca,et al.  Symptoms of anxiety and depression in patients with persistent asthma: a cross-sectional analysis of the INSPIRERS studies , 2023, BMJ Open.

[4]  Prabhoo Dayal,et al.  Association Between Comorbid Psychiatric Disorders and Persistent Smoking After a Diagnosis of Chronic Obstructive Pulmonary Disease Among Patients Seeking Treatment at a Tertiary Care Hospital in India , 2023, Cureus.

[5]  D. Janssen,et al.  “When I am breathless now, I don’t have the fear that’s linked to it”: a case series on the potential of EMDR to break the dyspnea-anxiety cycle in COPD , 2022, BMC Pulmonary Medicine.

[6]  A. Bugajski,et al.  Anxiety and Depressive Symptoms in Patients with COPD: Modifiable Explanatory Factors , 2022, Western journal of nursing research.

[7]  D. Rujescu,et al.  World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders – Version 3. Part I: Anxiety disorders , 2022, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[8]  V. Patella,et al.  Biologicals decrease psychological distress, anxiety and depression in severe asthma, despite Covid-19 pandemic , 2022, Respiratory Medicine.

[9]  Dingfang Liu,et al.  Investigation on the Relationship between Sleep Quality and Depression and Anxiety in Hospitalized Patients with Different Levels of AECOPD , 2022, Computational and mathematical methods in medicine.

[10]  A. Yohannes,et al.  Benefit–Risk Assessment of Psychotropic Drugs in Older Patients with Chronic Obstructive Pulmonary Disease , 2022, Drugs & Aging.

[11]  R. Casaburi,et al.  The effectiveness of pulmonary rehabilitation on chronic obstructive pulmonary disease patients with concurrent presence of comorbid depression and anxiety. , 2022, Respiratory medicine.

[12]  I. Rudan,et al.  Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis , 2022, The Lancet. Respiratory medicine.

[13]  R. Casaburi,et al.  Predictors of premature discontinuation and prevalence of dropouts from a pulmonary rehabilitation program in patients with chronic obstructive pulmonary disease. , 2022, Respiratory medicine.

[14]  S. Markowitz,et al.  The Relationship between Post Traumatic Stress Disorder and Self-management Behaviors in World Trade Center Workers with Asthma. , 2021, The journal of allergy and clinical immunology. In practice.

[15]  Chenying Fu,et al.  What conservative interventions can improve the long-term quality of life, depression, and anxiety of individuals with stable COPD? A systematic review and meta-analysis , 2021, Quality of Life Research.

[16]  E. Regan,et al.  Clinically Significant and Comorbid Anxiety and Depressive Symptoms Predict Severe Respiratory Exacerbations in Smokers: A Post-Hoc Analysis of the COPDGene and SPIROMICS Cohorts. , 2021, Annals of the American Thoracic Society.

[17]  R. Casaburi,et al.  Long-term benefits of pulmonary rehabilitation in COPD patients: a 2-year follow-up study. , 2020, Chest.

[18]  A. Campo‐Arias,et al.  Depression, perceived stress related to COVID, post-traumatic stress, and insomnia among asthma and COPD patients during the COVID-19 pandemic , 2020, Chronic respiratory disease.

[19]  N. Kalin Novel Insights Into Pathological Anxiety and Anxiety-Related Disorders. , 2020, The American journal of psychiatry.

[20]  P. Sullivan,et al.  Reproducible Genetic Risk Loci for Anxiety: Results From ∼200,000 Participants in the Million Veteran Program. , 2020, The American journal of psychiatry.

[21]  E. Hawkins,et al.  Center Predictors of Long-Term Benzodiazepine Use in Chronic Obstructive Pulmonary Disease and Posttraumatic Stress Disorder. , 2019, Annals of the American Thoracic Society.

[22]  Cheng-Ta Li,et al.  Post-traumatic stress disorder and asthma risk: A nationwide longitudinal study , 2019, Psychiatry Research.

[23]  A. Yohannes,et al.  Psychiatric Collaborative Care for Patients With Respiratory Disease. , 2019, Chest.

[24]  M. Ziman,et al.  Determinants for concomitant anxiety and depression in people living with chronic obstructive pulmonary disease. , 2019, Journal of psychosomatic research.

[25]  S. Bhar,et al.  The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: A randomized controlled trial. , 2017, British journal of health psychology.

[26]  A. Esterman,et al.  Psychological therapies for the treatment of anxiety disorders in chronic obstructive pulmonary disease. , 2017, The Cochrane database of systematic reviews.

[27]  M. Chung,et al.  Posttraumatic Stress Disorder Among Older Patients with Chronic Obstructive Pulmonary Disease , 2016, Psychiatric Quarterly.

[28]  Y. Kuo,et al.  Association of Psychological Disorders With 30-Day Readmission Rates in Patients With COPD. , 2016, Chest.

[29]  A. Blevins,et al.  Chronic obstructive lung disease and posttraumatic stress disorder: current perspectives , 2015, International journal of chronic obstructive pulmonary disease.

[30]  D. Mannino,et al.  Economic Burden of COPD in the Presence of Comorbidities , 2015, Chest.

[31]  P. J. Z. Teixeira,et al.  Post-traumatic Stress Symptoms and Exacerbations in COPD Patients , 2015, COPD.

[32]  G. Alexopoulos,et al.  Pharmacological Treatment of Depression in Older Patients with Chronic Obstructive Pulmonary Disease: Impact on the Course of the Disease and Health Outcomes , 2014, Drugs & Aging.

[33]  P. Austin,et al.  Benzodiazepine drug use and adverse respiratory outcomes among older adults with COPD , 2014, European Respiratory Journal.

[34]  A. Abernethy,et al.  Safety of benzodiazepines and opioids in very severe respiratory disease: national prospective study , 2014, BMJ : British Medical Journal.

[35]  A. Yohannes,et al.  The development and validation of the anxiety inventory for respiratory disease. , 2013, Chest.

[36]  A. Yohannes,et al.  Anxiety Disorders in Patients With COPD: A Systematic Review , 2013, Respiratory Care.

[37]  A. Esterman,et al.  Pharmacological interventions for the treatment of anxiety disorders in chronic obstructive pulmonary disease. , 2011, The Cochrane database of systematic reviews.

[38]  B. Nordestgaard,et al.  Myocardial infarction and other co-morbidities in patients with chronic obstructive pulmonary disease: a Danish nationwide study of 7.4 million individuals. , 2011, European heart journal.

[39]  A. Yohannes,et al.  Pulmonary rehabilitation in the United Kingdom , 2011, Chronic respiratory disease.

[40]  Nicola A Hanania,et al.  Anxiety and Depression in COPD: Current Understanding, Unanswered Questions, and Research Needs. , 2008, Chest.

[41]  B. Löwe,et al.  A brief measure for assessing generalized anxiety disorder: the GAD-7. , 2006, Archives of internal medicine.

[42]  Mark E Kunik,et al.  Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. , 2005, Chest.

[43]  Eirini Flouri,et al.  Post-Traumatic Stress Disorder (PTSD) , 2005, Journal of interpersonal violence.

[44]  A. Zigmond,et al.  The Hospital Anxiety and Depression Scale , 1983, Acta psychiatrica Scandinavica.

[45]  A. Yohannes,et al.  COPD and anxiety: its impact on patients' lives. , 2011, Nursing times.