Zusammenfassung
Hintergrund
Patienten mit chronisch obstruktiver Lungenerkrankung (COPD) leiden nicht allein unter pulmonalen Symptomen, sondern sind häufig durch weitere extrapulmonale Symptome belastet. Hierzu zählen auch psychische Komorbiditäten wie Ängste und Depressionen, welche das Krankheitsgeschehen nachhaltig beeinflussen können.
Fragestellung
Was wissen wir über Prävalenz und Folgen von Ängsten und Depressionen bei Patienten mit COPD, deren möglichen Ursachen sowie Diagnostik und Behandlung?
Material und Methoden
Identifikation, Zusammenstellung und Diskussion relevanter Forschungsliteratur, Überblick über den aktuellen Forschungsstand.
Ergebnisse
Komorbide Ängste und Depressionen sind bei COPD-Patienten und deren Angehörigen weit verbreitet und mit deutlich negativerem Krankheitsgeschehen verbunden. Die genauen Ursachen hierfür sind weitgehend ungeklärt und beinhalten vermutlich komplexe Wechselwirkungen zwischen psychologisch/verhaltensbezogenen und peripherphysiologisch/neuronalen Prozessen. Psychische Komorbiditäten bei COPD werden zu selten entdeckt und behandelt. Verschiedene anxiolytische oder antidepressive Interventionsformen scheinen bei COPD-Patienten wirksam zu sein, bedürfen aber weiterer systematischer Untersuchung.
Schlussfolgerung
Komorbide Ängste und Depressionen bei COPD-Patienten sind ein enormes Gesundheitsproblem und erfordern verstärkte Forschungsaktivität. Neben einem tieferen Verständnis der unterliegenden Mechanismen und Wechselwirkungen, muss vor allem der verbesserten Diagnostik und Behandlung dieser psychischen Komorbiditäten im klinischen Alltag mehr Beachtung geschenkt werden.
Abstract
Background
Patients with chronic obstructive pulmonary disease (COPD) suffer not only from pulmonary symptoms but also from additional extrapulmonary symptoms. These include psychological comorbidities, such as anxiety and depression, which can significantly influence the course of the disease.
Objectives
What is known about the prevalence and consequences of anxiety and depression in patients with COPD, the potential causes as well as diagnostics and treatment?
Material and methods
This article describes the identification, compilation and discussion of relevant research literature and gives a review of the current state of research.
Results
Comorbid anxiety and depression are widespread in COPD patients and their relatives and are associated with a considerably worse course of the disease. The exact causes for these findings are largely unclear but presumably include complex interactions between psychological, behavioral, peripheral physiological and neural processes. Psychological comorbidities often remain undetected and untreated in COPD patients. Several anxiolytic and antidepressive interventions seem to be effective in patients with COPD but these require further systematic study.
Conclusion
Comorbid anxiety and depression in patients with COPD are significant health problems, which require intensified future research activities. Besides an improved understanding of the underlying mechanisms and interactions, improvement of detection and treatment of these psychological comorbidities in the daily clinical routine in particular need to receive greater attention.
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von Leupoldt, A. COPD und psychische Komorbiditäten. Pneumologe 13, 156–165 (2016). https://doi.org/10.1007/s10405-015-0026-x
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DOI: https://doi.org/10.1007/s10405-015-0026-x