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Psychische Rauchstoppbarrieren

Zum Zusammenhang von Rauchen und Depressionen bei COPD-Patienten

Mental barriers to quitting smoking

The association between smoking and depression in COPD patients

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Der Pneumologe Aims and scope

Zusammenfassung

Hintergrund

Die Lebenszeitprävalenz des Tabakrauchens unter COPD-Patienten liegt mit 80 % weit über dem Bevölkerungsdurchschnitt. Das Zigarettenrauchen stellt unbestritten den ätiologischen Hauptfaktor für die chronisch obstruktive Lungenerkrankung (COPD) dar. Insgesamt werden etwa 80–90 % der COPD-Morbidität auf das Tabakrauchen zurückgeführt. Langfristig bildet fast jeder zweite regelmäßige starke Raucher eine COPD aus.

COPD und Komorbidität

Durch eine wirksame Prävention des Tabakrauchens wäre ein Großteil der COPD-Inzidenz zu verhindern bzw. die Langzeitprognose der Erkrankung entscheidend zu verbessern. Allerdings gelingt unter den bereits an COPD erkrankten symptomatischen Patienten nur einem Teil die Tabakentwöhnung. COPD-Patienten weisen zugleich eine weit überdurchschnittliche psychische Komorbidität (Lebenszeitprävalenz klinischer Depressionen > 30 %; Prävalenz subklinischer depressiver Symptome bis 60 %) auf.

Diskussion

In diesem Beitrag werden mögliche interdependente Zusammenhänge zwischen Depressivität und Tabakrauchen bei COPD-Patienten diskutiert und Empfehlungen für die klinische Praxis angeregt.

Abstract

Background

The lifetime prevalence of tobacco smoking among chronic obstructive pulmonary disease (COPD) patients is 80 %. This exceeds the population average considerably. Cigarette smoking constitutes the aetiological key factor for COPD. About 80 to 90 % of COPD morbidity is due to tobacco smoking. In the long term, about one in two heavy smokers develop COPD.

COPD and Comorbidity

The majority of COPD incidence could be reduced or the long-term prognosis could be significantly improved by means of effective prevention of tobacco smoking. However, only a small proportion of symptomatic COPD patients are able to successfully complete smoking cessation programmes. Co-occurring psychological comorbidity in COPD patients (lifetime prevalence of clinical depression > 30 %; prevalence of subthreshold depressive symptoms up to 60 %) is far above average.

Discussion

This article discusses potential interrelations among depressiveness and tobacco smoking in patients with COPD and provides recommendations for clinical practice.

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  1. Klinische Psychologie und Psychotherapie, TU Chemnitz, Wilhelm-Raabe-Str. 43, 09107, Chemnitz, Deutschland

    S. Mühlig & J. Paulick

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S. Mühlig unterhielt eine einmalige bezahlte Vortragstätigkeit für Pfizer und Mundipharma. J. Paulick gibt an, dass kein Interessenkonflikt besteht.

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Mühlig, S., Paulick, J. Psychische Rauchstoppbarrieren. Pneumologe 13, 174–180 (2016). https://doi.org/10.1007/s10405-015-0028-8

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