Table 1. Association, symptoms, impact and treatment options for depression and anxiety in chronic obstructive pulmonary disease
Association and clinical implications
    Elevated systemic inflammation, e.g. interleukin-6, C-reactive protein
    Use of long-term oxygen therapy
    Increase in the number of comorbidities
    Prolongs length of hospital stay
    Increase in the number of consultations with general practitioners
    Morbidity and mortality
    Female sex
    Escalates frequency of hospital readmission
    Heightens the number of acute exacerbations
    Severe respiratory impairment
    Health-endangering behaviour (smoking)
    Increased fatigue
    Social withdrawal
    Lack of interest in pleasurable activities
    Dyspnoea on exertion
Impact on physical and social functioning
    Reduced exercise capacity
    Increased physical disability
    Reduced social interaction
    Dependence on caregivers
    Emotional liability
    Loss of social role
    Loss of libido
    Decrease in cognitive functioning
    Early retirement from work
    Loss of self-esteem
Treatment options
    Support and adherence to exercise and antidepressant treatment
    Pulmonary rehabilitation
    Personalised intervention
    Collaborative care model
    Smoking cessation
    Relaxation therapy
    Antidepressant drug therapy
    Psychotherapy (cognitive behavioural and supportive)
    Social support and respite care for caregivers
    Telephone health mentoring using cognitive behavioural therapy