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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Once a diagnosis of COPD is suspected, history, physical examination, pulmonary function tests, chest roentgenogram, sputum analysis, and so forth, are useful to assess the severity of obstructive airways diseases. A comprehensive program of care is then outlined (Table 2). General measures include avoidance of infection and inhalants, humidification, and proper rest and diet. Appropriate medications may include bronchodilators, antibiotics, corticosteroids, cromolyn sodium, digitalis, and diuretics. Inhalation therapy as aerosols, IPPB, and supplemental oxygen may be indicated. Physical therapy with postural drainage, exercise reconditioning, and occupational therapy deserve attention. The day-to-day care of the vast majority of patients with COPD is managed by primary care physicians. This systematic approach to pulmonary rehabilitation will yield definite rewards. Patients will feel and perform better. They will note an improved exercise tolerance, leading to increased activities of daily living. They will experience reduction in the frequency and duration of hospitalization as well as a decrease in anxiety and depression with an improved quality of life.
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PMID:Comprehensive care in chronic obstructive pulmonary disease. 82 54

The effects of 1.0 per cent end-tidal halothane-oxygen anesthesia on spontaneous ventilation, ventilatory deadspace, functional residual capacity (FRC), and alveolar-arterial oxygen difference (A-aD-O-2) were measured in patients with chronic obstructive pulmonary disease and in normal patients of similar age. results obtained were compared with values obtained preoperatively from the same patients. The following were measured: 1) ventilation and ventilatory deadspace, breathing room air and breathing 100 per cent oxygen; 2) functional residual capacity (FRC) and alveolar-arterial oxygen tension difference (A-aD-O-2); 3) forced expiratory volume in 1 second (FEV1.0); 4) ventilatory response to exogenous carbon dioxide. Findings indicated that ventilation is depressed more during halothane anesthesia in patients with emphysema than in normal patients and that the extent of depression is best related to a preoperative measurement of FEV1.0 (P less than 0.001, r = 0.86). The depression in alveolar ventilation results primarily from a reduction in tidal volume. A-aD-O-2 and ventilatory deadspace-to-tidal volume ratio are increaded and FRC decreased with anesthesia in patients with COPD, but the changes are no greater than those found in normal patients.
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PMID:Anesthetic effects on ventilation in patients with chronic obstructive pulmonary disease. 111 64

Thirty two patients with severe COPD were studied. We evaluated relationships between their psychological status, lung function parameters, exercises tolerance (6 MWD test) and dyspnea at rest and exercise (visual analogue scale). Patients demonstrated increased level of anxiety and psychological tension. In nearly half of the patients depression, low self-esteem and disbelief in the efficiency of therapy were observed. The correlations between the psychological status and the exercise tolerance hasn't been found. The correlation between the high level of depression and impairment of the lung function was found. The high increase in dyspnea score during exercises was connected with low self-esteem, although at rest the dyspnea level in those patients was low.
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PMID:[Dyspnea at rest and after exercise and the mental status of patients with chronic obstructive lung diseases]. 129 32

The aim of this study is to verify the psychological attitude and the quality of life in patients suffering from chronic respiratory insufficiency. Taking for granted that a bad quality of life is connected with the symptom of a depressed state (loss of appetite, quality of sleep, sexuality, psychomotor slowing down, loss of energy, weariness, reduced interest for the external world, feelings of self-devaluation, reduced working and concentration capacity, complainings of turning over type) we have taken as index of "normal quality of life" the lack of these attitudes correlating them to the clinical symptoms and/or the patient's functional troubles and verifying how much they can affect the psychological features and how much the deterioration of the quality of life. For this reason a questionnaire, taken from the MMPI test (Minnesota Multiphasic Personality Inventory), restricted to the items related to the D scale (depression scale), has been given to one hundred COPD patients who had been examined previously from a clinical functional point of view. In the end, we have drawn our results both on the ground of the answers given by the patients to the single questions and on the grounds of the total score D (= depression index) and relating the previous data with the clinical-functional ones. Finally we have compareted these data with those ones connected with non selected population. So we have succeeded in outlining a psychophysical profile of the patient suffering from chronic respiratory diseases. Such a profile is marked by an objective element, that is pathology, and by a psychological element inserted into the organic one as there is an inter-dependence between pathology and psychological features. From the collected data, we have noted the behavioural spheres which are more upset are working capacities, sleep and mood and these features are directly proportional to the seriousness of the pathology. From a practical and therapeutic point of view, all this can be of great importance.
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PMID:[Quality of life and psychologic features of subjects with chronic respiratory diseases]. 130 34

A need was identified for a fixed-format self-complete questionnaire for measuring health in chronic airflow limitation. A 76-item questionnaire was developed, the St. George's Respiratory Questionnaire (SGRQ). Three component scores were calculated: symptoms, activity, and impacts (on daily life), and a total score. Three studies were performed. (1) Repeatability was tested over 2 wk in 40 stable asthmatic patients and 20 patients with stable COPD. The coefficient of variation for the SGRQ total score was 19%. (2) SGRQ scores were compared with spirometry, 6-min walking distance (6-MWD), MRC respiratory symptoms questionnaire, anxiety, depression, and general health measured using the Sickness Impact Profile score. A total of 141 patients were studied, mean age 63 yr (range 31 to 75) and prebronchodilator FEV1, 47% (range 11 to 114%). SGRQ scores correlated with appropriate comparison measures. For example, symptom score versus frequency of wheeze, r2 = 0.32, p less than 0.0001; activity versus 6-MWD, r2 = 0.50, p less than 0.0001; impact versus anxiety, r2 = 0.38, p less than 0.0001. Multivariate analysis demonstrated that SGRQ scores summed a number of areas of disease activity. (3) Changes in SGRQ scores and other measures were studied over 1 yr in 133 patients. Significant correlations were found between changes in SGRQ scores and the comparison measures (minimum r2 greater than 0.05, p less than 0.01). Multivariate analysis showed that change in total SGRQ score summed changes in a number of aspects of disease activity. We conclude that the SGRQ is a valid measure of impaired health in diseases of chronic airflow limitation that is repeatable and sensitive.
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PMID:A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. 159 97

This study assessed physiologic, psychological, and cognitive functioning in outpatients with COPD. Sixty-four subjects, 53 to 82 years of age, participated in the 30-day exercise rehabilitation program. The program consisted of exercise, education and psychosocial counselling. Participants were assessed prior to beginning the program and at the end of 30 days. Assessments at both times included physiologic functioning (bicycle ergometry testing, pulmonary function tests, 12-min walk), psychological well-being (anxiety, depression, psychiatric symptoms, perceived well-being) and an abbreviated neuropsychological test battery. Results indicate significant improvement in physical endurance and pulmonary function, significant reductions in symptoms of depression and anxiety, and improvement in measures of general well-being and neuropsychological functioning. The study suggests that exercise rehabilitation of older adults with COPD contributes not only to improvements in physical functioning and endurance, but also to enhanced cognitive functioning and psychological well-being.
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PMID:Psychological outcomes of a pulmonary rehabilitation program. 188 42

The aim of the study was to evaluate the psychical state of 48 patients with chronic respiratory failure in the course of COPD qualified for home oxygen therapy. The psychical state was analysed using the following tests: thorough clinical history, J. Taylor's evident anxiety scale, H. Gough's adjective scale and psychological rehabilitation effectiveness scale according to J. Tylka. The study showed that the majority of patients demonstrated high levels of fear, depression and anxiety, lowered self evaluation, negative attitude toward work, lack of life aims and disbelief in therapy benefit. Correlation between degree of primary disease and lowered self-being could not be demonstrated. The decisive effect had socio-economic situation and individual traits.
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PMID:[Psychological state of patients with chronic obstructive pulmonary disease]. 263 Oct 50

Steroid therapy has become part of the adjunctive treatment for COPD patients in some settings. Emotional changes have been reported in some patients while on these medications, but whether these changes are associated with the pathophysiological state or a side effect of the medication is not known. In this study self-reports of depression and somatic complaints were compared between two groups of COPD patients, 20 not receiving steroids and 20 receiving steroids. Both groups demonstrated comparable levels of disease and somatic complaints. Mean FEV1 value for those not receiving steroids was 34% of predicted while the mean for those receiving steroids was 30% of predicted. Depression was found to be significantly higher (t = 11.21, df = 38, p less than 0.01) in the group receiving steroids when compared to those not receiving steroids using a Student's t test. The higher degree of depression among steroid treated COPD patients has implications for clinical practice. The emotional status of this group of patients needs to be monitored and interventions initiated when necessary.
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PMID:Depression, somatization and steroid use in chronic obstructive pulmonary disease. 276 12

Serious respiratory depression has been described in COPD patients receiving hypnotics during acute exacerbations. There are few studies quantifying the effects of hypnotics on oxygenation during sleep in patients with stable hypoxemic COPD. In this study, the effects of single therapeutic doses of nitrazepam and flunitrazepam on SaO2, apneas during sleep and other sleep variables were measured in 14 COPD patients. All patients used theophylline. Sleep-induced decrease in mean SaO2 was 1.3 percent after placebo, 1.4 percent after nitrazepam and 1.9 percent after flunitrazepam (no significant differences). Sleep apneas were not more common or longer after nitrazepam or flunitrazepam, but sleep quality seemed to improve. It is concluded that oxygenation during sleep in these nonobese patients with stable hypoxemic nonhypercapnic COPD, all on maintenance theophylline therapy, was affected very little by single therapeutic doses of nitrazepam or flunitrazepam.
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PMID:The effects of nitrazepam and flunitrazepam on oxygen desaturation during sleep in patients with stable hypoxemic nonhypercapnic COPD. 292 6

The objective of this study was twofold: (1) to document the prevalence of depression and anxiety in patients with moderate or severe chronic obstructive pulmonary disease; and (2) to determine whether the presence of depression or anxiety adversely affected the functional capabilities of the patient as reflected by the distance he could walk in 12 minutes. Forty-five patients with an FEV1 less than 1,250 ml underwent pulmonary function testing including spirometry, single breath diffusing capacity, and arterial blood gas determinations. The degree of depression was assessed by the Beck depression inventory, while the degree of anxiety was assessed by the State-Trait anxiety inventory. Forty-two percent of the patients had significant depression, while only 2 percent of the patients had significant anxiety. There was a highly significant correlation between the depression scores and the anxiety scores (r = 0.81, p less than 0.001). There was no significant correlation between the level of depression or anxiety and the distance that the patient could walk in 12 minutes. From this study, we conclude that the prevalence of depression in patients with moderate or severe COPD approaches 50 percent while the incidence of anxiety is much lower (2 percent).
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PMID:Prevalence of depression and anxiety in patients with COPD. Relationship to functional capacity. 396 63


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