Mental health disorders are often overlooked in COPD patients

Mental health disorders in people with chronic obstructive pulmonary disease (COPD) are underdiagnosed and undertreated, leading to worsened symptoms and decreased quality of life, according to a new study. The study is published in the January 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal.

COPD is an inflammatory lung disease, comprising several conditions, including chronic bronchitis and emphysema, and can be caused by genetics and irritants like smoke or pollution. The disease affects more than 30 million Americans and is the fourth leading cause of death worldwide.

Depression and anxiety are common comorbidities in people with COPD, which lead to increased symptom burden and decreased quality of life. Screening questionnaires often are used to detect symptoms of these disorders in people with COPD; however, these screening tools cannot be used definitively to confirm their diagnosis.

This study is a cross-sectional, secondary analysis of the Anxiety and COPD Evaluation, a national, multicenter observational survey study to evaluate anxiety questionnaires in people with COPD. The analysis implemented the Mini-International Neuropsychiatric Interview (MINI) to identify those participants who could be diagnosed with depression and/or anxiety disorders.

Of the 220 eligible participants, 18 (8%) met the MINI criteria for depression and 17 (8%) met the MINI criteria for anxiety. Among those meeting the criteria for a depression or anxiety diagnosis, fewer than half were receiving mental health counseling or using antidepressants, affirming a persistent care gap.

The study also demonstrated that depression and anxiety were associated with increased breathlessness, reduced functionality, worse sleep quality and decreased quality of life.

People with COPD are sometimes screened for mental health disorders using questionnaires; however, they lack the ability to confirm the diagnosis of depression and anxiety and thus may hinder those with the diagnosis from receiving appropriate mental health care. Our study demonstrates the need to appropriately diagnose mental health disorders in people with COPD to help reduce symptom burden and improve quality of life. Further research is needed to determine how treating mental health disorders could improve outcomes for people with COPD over time."

Jing Gennie Wang, M.D., pulmonologist at The Ohio State University Wexner Medical Center and first author of the study