慢性阻塞性肺病、抑郁症和COVID-19大流行:一个令人痛苦、令人沮丧和有害的三位一体

Iqbal Akhtar Khan, Hamza Iltaf Malik
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引用次数: 1

摘要

慢性阻塞性肺病是一个高度致残的全球公共卫生问题,具有肺部和肺外表现,通常伴有严重的慢性疾病。随着了解的加深,它被广泛报道为一种复杂的、异质性的和动态的疾病,影响患者的肺部以外的健康。抑郁症的患病率为3.22亿人,是造成全球总体疾病负担的一个主要因素。在各种流行病学和临床研究中,其在COPD患者中的患病率从18%到80%不等。这一致命的双重因素导致了过高的医疗保健使用率和成本,包括病情加重率上升、对处方药的依从性欠佳、住院人数增加、住院时间延长和再入院人数增加。此外,自杀意念、自杀企图和自杀药物过量的风险也会增加。遗憾的是,在许多病例中,合并症仍未得到充分认识和治疗。讨论了当前的COVID - 19大流行对慢性阻塞性肺病和抑郁症双重负担的影响,以及可能的补救措施,包括“促进健康的六种方法”(英国心理健康中心),“与时俱进”工具包(世卫组织)以及舞蹈动作疗法和音乐参与疗法等创新附加疗法。
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COPD, Depression and COVID-19 Pandemic: A Harrowing, Demoralizing and Deleterious Triad
COPD is a highly incapacitating global public health problem, with pulmonary and extra-pulmonary manifestations and usually associated with significant concomitant chronic diseases. With enhanced understanding, it has extensively been reported as a complex, heterogeneous and dynamic disease affecting patients’ health beyond pulmones. Depression, with prevalence of 322 million people, is a major contributor to the overall global burden of disease. In various epidemiological and clinical studies, its prevalence among patients with COPD varies from 18% to 80%. This deadly duo leads to excessive health care utilization rates and costs including increased rates of exacerbation, sub-optimal adherence to prescribed medications, increased hospital admissions, longer hospital stays and increased hospital readmissions. Moreover, there is increased risk of suicidal ideation, suicidal attempts, and suicidal drug overdose. It is a pity that, in significant cases, the co-morbidity remains under-recognized and under-treated. The impact of prevailing COVID 19 pandemic, on the dual burden of COPD and depression, and possible remedial measures including “The 6 ways to boost one’s well-being-by Mental Heath UK, “The Living with the Times” toolkit--by WHO” and innovative add-ons like Dance Movement Therapy and Musical Engagement Therapy have been discussed.
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