Links between panic disorder, depression, defence mechanisms, coherence and family functioning in patients suffering from severe COPD
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Psychiatr Pol 2008;42(5):731–748
Chronic Obstructive Pulmonary Disease (COPD) is a slowly progressive lung disorder characterised by airflow obstruction. It is one of the major causes Of morbidity, disability and mortality in the older population. Comorbid psychiatric and psychological impairments (depression and anxiety, most often panic disorder) are common in COPD. They impair the quality of life in COPD severely and are often not fully explored in the clinical management of COPD patients. Aim. The aim of our study was to assess the prevalence of anxiety (especially panic disorder) and depression among patients with COPD. A secondary objective was to find Out a correlation between the psychological aspects (defence style, sense of coherence and family functioning) and psychiatric symptoms. Methods. The authors examined 45 patients suffering from severe COPD (according to GOLD classification) during their present hospitalisation. There were 19 women (42%) and 26 men (58%). The average age was M=64.56 years (SD=10.64), and the average duration of illness was M=10.53 years (SD=10.18). Mini International Neuropsychiatric Interview, Polish version 5.0.0, Panic and Agoraphobia Scale, Beck's Depression Inventory, Family Functioning Questionnaire (KOR), Sense of Coherence Scale (SOC-29), Defence Style Questionnaire (DSQ-40) and Life Inventory were used. Results. The study revealed that 44.4% of the group with severe COPD were patients who suffered also from panic disorder and 40% from depression. Depression was linked with more severe panic symptoms. All psychiatric symptoms were associated with a psychological problems. Conclusion. It is highly possible, that psychiatric and psychological problems affect the quality of lite, self-management and treatment outcome in patients with COPD.