Depression and anxiety in chronic pulmonary diseases

Depression and anxiety disorders are common in patients with chronic pulmonary diseases. Evidence from epidemiological studies confirmed the coexistence of chronic obstructive pulmonary disease and depression in 10-50% of patients. Similar prevalence was found in asthma. Organic factors including hypoxia, increased activity of proinflammatory cytokines and psychosocial consequences of pulmonary disease may play a role in pathogenesis of depression in patients with pulmonary disease. Comorbidity of asthma and anxiety disorders was found in several studies. Past and present pulmonary diseases are risk factors of anxiety disorders. Pathogenetic mechanisms remain unclear but both psychological and organic factors seem to play a role. The coexistence of respiratory and psychiatric disorders has a negative impact on severity of symptoms, and is associated with lower functional status and higher drug utilization. Selective serotonin reuptake inhibitors and psychotherapy are effective and safe in reducing both depressive and anxiety symptoms in the course of chronic pulmonary diseases.