Pulmonology
Pulmonary diseases, such as asthma or COPD, can have significant implications for mental health. The stress of managing a chronic respiratory condition, or the anxiety associated with breathing difficulties, can impact psychological well-being. The Journal of Clinical Psychiatry explores this relationship, offering insights into the mental health challenges faced by individuals with pulmonary diseases and strategies for holistic care. Our expert editors ensure content is comprehensive and relevant, bridging the gap between pulmonology and psychiatry.
ORIGINAL RESEARCH
Antipsychotics may have immunomodulatory effects that could increase the risk of disseminated infections. This study sought to estimate the effect of antipsychotics on incident bloodstream infections in adults with chronic obstructive pulmonary disease.
J Clin Psychiatry 2021;82(3):20m13516
Augusto Ferraris and others
ORIGINAL ARTICLES
Article Abstract
Objective: Depression is common among patients with chronic obstructive pulmonary disease (COPD). Patients with COPD may be more likely to have inadequate treatment with antidepressant medications. We tested the hypothesis that depressed patients with COPD have lower odds of adequate duration of antidepressant therapy in the first 3 months of treatment compared to those without COPD.
Method: Using administrative and centralized pharmacy data from 14 northeastern Veterans Affairs Medical Centers, we identified 778 veterans with depression (ICD-9-CM codes 296.2x, 296.3x, and 311.xx) who were in the acute phase of antidepressant treatment from June 1, 1999, through August 31, 1999. Within this group, we identified those patients with COPD (23%). An adequate duration of antidepressant treatment was defined as > = 80% of days on an antidepressant. We used multivariable logistic regression models to determine the adjusted odds of adequate acute phase antidepressant treatment duration.
Results: Those patients with COPD had markedly lower odds of adequate acute phase treatment duration (odds ratio = 0.67, 95% CI = 0.47 to 0.96); this was not observed with other medical diagnoses such as coronary heart disease, diabetes mellitus, or osteoarthritis.
Conclusions: The first few months of treatment appears to be a critical period for depressed patients with COPD who are started on antidepressants. The causes for early antidepressant treatment inadequacy among patients with COPD require further investigation. More intensive efforts may be necessary early in the course of treatment to assure high-quality pharmacologic therapy of depressed patients with COPD.
Prim Care Companion J Clin Psychiatry 2006;8(2):71-76
Paul A. Pirraglia Andrea Charbonneau Boris Kader Dan R. Berlowitz
ORIGINAL ARTICLES
Article Abstract
Background: Asthma is a sometimes severe respiratory illness with an increased prevalence, especially in low-income, minority, and inner- city populations, over the past 2 decades. Prior reports have suggested a link between depression and asthma deaths. However, no studies have examined the relationship between objective measures of asthma severity and clinician-rated depressive symptom severity.
Method: In this pilot study, 46 children receiving treatment at an inner-city asthma clinic were assessed with the Children's Depression Rating Scale, Revised (CDRS-R). The current percentage of forced expiratory volume in 1 second (FEV1%) predicted and the inhaled steroid dose were recorded, as were oral steroid use, emergency room visits, and hospitalizations in the preceding year.
Results: Depressive symptoms were common in this sample, with 30% (N = 14) of the participants having CDRS-R scores consistent with likely, very likely, or almost certain major depressive disorder. When mean CDRS-R scores were compared between the sample divided by these asthma severity measures, only hospitalizations in the past year was associated with higher depressive symptom scores (p = .03).
Conclusion: These findings suggest that in the patient sample studied, depressive symptoms appear to be common. However, depressive symptom severity is related only to hospitalization, not other measures of asthma severity. Larger studies are needed to confirm these findings and determine if other variables such as family history of depression or subjective assessment of asthma severity explain the high prevalence of depressive symptoms in these patients.
Prim Care Companion J Clin Psychiatry 2002;4(5):174-177
Kristine M. Morrison and others
ORIGINAL ARTICLES
Article Abstract
Background: Asthma and depression are both common illnesses. Data suggest that the prevalence of asthma and asthma-related morbidity and mortality has increased in the past 2 decades. Asthma has long been considered an illness in which mood and emotions contribute to symptom exacerbation. Therefore, we reviewed the recent literature on depression in persons with asthma.
Data Sources: The MEDLINE (1966-1999) and PSYCHINFO (1967-1999) databases were used to find English-language articles on asthma and depression. Search terms included asthma, depression, dysthymia, and mood.
Data Synthesis: This literature suggests depressive symptoms are more common in asthma patients than in the general population and perhaps even more common than in some other general medical conditions. Depression may be associated with asthma morbidity and mortality. Limited data suggest the older tricyclic antidepressants may improve both depression and asthma symptoms. However, no studies have examined the use of second-generation antidepressants in asthma patients.
Conclusion: Depressive symptoms are common in asthma patients. However, the prevalence of depressive disorders in this population is not well determined. Future studies should focus on determining the prevalence of major depressive disorder in this population and the effect of antidepressants on mood and asthma symptoms.
Prim Care Companion J Clin Psychiatry 2000;2(5):153-158
Tanya A. Zielinski and others
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