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Depression and anxiety are common in people with chronic obstructive pulmonary disease and are associated with significant distress, increased morbidity and mortality, and reduced functioning and quality of life.
- There is a bidirectional relationship between depression and medical illness.
- Comorbid depression and anxiety are associated with more severe medical illness, increased morbidity and mortality, increased functional disability and poorer quality of life.
- Comorbid depression is associated with increased presentations to healthcare services and increased costs of care.
- Treating depression and anxiety may reverse this cascade.
- All patients with obstructive pulmonary disease should be screened for depression and anxiety.
- Recommended treatments include antidepressants, psychotherapy and pulmonary rehabilitation, although evidence is limited.
- Any other medications or medical conditions that might be contributing to depression should be identified and managed.