Med/Psych Update

COPD comorbid with mental illness: What psychiatrists can do

Current Psychiatry. 2016 May;15(5):68-74

References

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Referral to a pulmonologist is strongly advised in cases of:

advanced, end-stage COPD (FEV1 <50% predicted value despite adherence to recommended treatment, or rapid decline of FEV1)
COPD in patients age <50
frequent exacerbations
possible complications related to chronic heart failure
indications for oxygen treatment (eg, resting or ambulatory oxygen saturation ≤88% or PaO₂ ≤55 mm Hg).³²

Bottom Line
Chronic obstructive pulmonary disease (COPD) is a common condition with high morbidity and mortality. Comorbid COPD and tobacco smoking is especially prevalent in people with mental illness. Early diagnosis of COPD is important because appropriate management can alleviate symptoms, improve health status and exercise capacity, and prolong survival. You can play an integral role in COPD management by promoting smoking cessation and encouraging adherence to treatment.

Related Resources

Agency for Healthcare Research and Quality. Help for smokers and other tobacco users: quit smoking. www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/tearsheets/helpsmokers.html.
Mayo Clinic. Diseases and conditions: COPD. www.mayoclinic.com/health/copd/DS00916.

Criner GJ, Bourbeau J, Diekemper RL, et al. Prevention of acute exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest. 2015;147(4):894-942.

Global Initiative for Chronic Obstructive Lung Disease. Guidelines for professionals in the diagnosis and treatment of COPD. www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html.

Drug Brand Names
Bromocriptine • Parlodel
Bupropion • Wellbutrin SR, Zyban
Buspirone • BuSpar
Clozapine • Clozaril
Fluvoxamine • Luvox
Haloperidol • Haldol
Nortriptyline • Pamelor
Olanzapine • Zyprexa
Theophylline • Theolair
Varenicline • Chantix

Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

COPD comorbid with mental illness: What psychiatrists can do

References

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