Key result
Anxiety and depression in stable COPD strongly correlate with poorer QoL, increased exacerbations, and higher mortality.
Why the study?
Psychological comorbidities, especially anxiety and depression, are common in COPD and strongly influence health-related quality of life, healthcare utilization, and clinical outcomes.
Anxiety and depression are highly prevalent in COPD and substantially degrade quality of life, highlighting the need for routine screening and integrated management.
High rates of depression/anxiety in COPD link to poorer QoL; confirms associations yet leaves open intervention effects in trials.
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide.Psychological comorbidities, especially anxiety and depression, are common in COPD and strongly influence health-related quality of life (HRQoL), healthcare utilization, and clinical outcomes.Objectives: To provide a comprehensive narrative review of the prevalence, mechanisms, clinical consequences, assessment, and management of anxiety and depression in COPD, with a focus on implications for quality of life (QoL) and practice in India.Methods: Narrative synthesis of contemporary literature (2010-2025), including systematic reviews, meta-analyses, randomized controlled trials, and pertinent observational studies.Results: Prevalence estimates vary by setting and assessment method, with pooled estimates suggesting that approximately 25-40% of stable COPD patients have clinically significant depressive symptoms and 20-46% have anxiety.Anxiety and depression correlate strongly with poorer QoL (pooled correlations: depression r ≈ 0.45-0.50;anxiety r ≈ 0.30-0.40),increased exacerbations, hospital admissions, worse adherence, and higher mortality.Mechanisms are multidimensional biological (inflammation, hypoxia), behavioral (inactivity, nonadherence), and cognitive/ affective (catastrophizing, reduced self-efficacy).Pulmonary rehabilitation (PR), exercise interventions, cognitive-behavioral therapies, and targeted pharmacotherapy improve symptoms and HRQoL in many patients.Conclusions: Anxiety and depression substantially degrade QoL in COPD.Routine screening and integrated management-combining pulmonary, psychological, and social care-are essential.In India, scalable models using community health workers, telemedicine, and culturally adapted psychological interventions should be prioritized.
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Raj et al. (2026) conducted a review in Chronic Obstructive Pulmonary Disease (COPD). Anxiety and depression was evaluated on Quality of Life (QoL). Anxiety (20-46% prevalence) and depression (25-40% prevalence) in stable COPD patients strongly correlate with poorer quality of life (r ≈ 0.30-0.50), increased exacerbations, and higher mortality.
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