Revista NCT

Factores psicológicos asociados a la enfermedad pulmonar obstructiva crónica: una revisión narrativa

Hernández-Pérez, Andrea^1,2; Vargas-Núñez, Inés²; Pérez-Padilla, Rogelio^1,2; Ramírez-Venegas, Alejandra¹

2022, Número 1

2022; 81 (1)

RESUMEN

La enfermedad pulmonar obstructiva crónica (EPOC) es la tercera causa principal de muerte a nivel mundial, y la carga de la enfermedad aumenta por múltiples comorbilidades, incluidos algunos trastornos psicológicos, como ansiedad y depresión, entre otros. Esta interacción entre la salud mental y la EPOC se ha convertido en un tema de intenso estudio en los últimos años. Nuestro objetivo fue describir los factores psicológicos asociados con la EPOC, la interacción de factores que conducen a un impacto en la enfermedad y analizar las alternativas de tratamiento e intervención efectivas disponibles. Se realizó una búsqueda de literatura narrativa en PubMed y Cochrane Library, utilizando una técnica de búsqueda de bola de nieve para identificar artículos publicados sobre el tema. Se realizó una búsqueda de artículos originales relevantes con énfasis en los años 2015-2021. Fue relevante el énfasis de un equipo multidisciplinario de apoyo a los pacientes con EPOC, resulta relevante la evaluación de factores psicológicos asociados a la enfermedad, especialmente ansiedad y depresión. Los tratamientos disponibles, incluidas las intervenciones psicológicas, demostraron una mejora en la calidad de vida, adherencia a los tratamientos, reducción de hospitalizaciones, sintomatología y exacerbaciones.

PALABRAS CLAVE

EPOC, salud mental, ansiedad, depresión, trastorno psiquiátrico, factores de riesgo.

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2022, Número 1

2022; 81 (1)

Figura 1

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Tabla 1

Table 1: Summary of publications regarding the association between psychological factors and pulmonary obstructive chronic disease.
Outcome measures / Reference	Odds ratio - risk ratio - adjusted odds ratio - hazard ratio	Other factors found
Depression and emergency hospital admissions12 Depression and attendances at emergency departments	OR = 2.63; 95% CI (1.48-4.66) OR = 2.78; 95% CI (1.55-4.99)	Even mild symptoms and moderate to severe symptoms of depression increase the risk of use of urgent care, these findings are independent of severity of disease and comorbidity of other chronic physical conditions
COPD and the likelihood of suicide13	OR = 1.90; 95% CI (1.27-2.48)	Similarly, risk factors associated with suicide, such as mental disorders, are underdiagnosed and undertreated
Comorbid depression and risk of mortality14	RR = 1.83; 95% CI (1.00-3.36).	COPD increases the risk of developing depression (RR = 1.69; 95% CI 1.45-1.96)
Bipolar disorder and COPD15 Schizophrenia and COPD16	OR 1.55; 95% CI (1.45-1.65) OR 1.57; 95% CI (1.43-1.72)	The most important confounding factor the contribution of which must be evaluated to clarify the nature of the association between COPD and major mental illness is the smoking
Stress with acute care use in COPD	AOR = 2.51; 95% CI (1.06-5.98)	The high stress group had a 2.5-fold increased adjusted odds of acute care use compared to the low stress group
Physical activity-depression in COPD17 PA-anxiety in COPD	HR = 0.85; 95% CI (0.75-0.95) HR = 0.89; 95% CI (0.79-1.00)	The study found more physically active patients [with higher PA levels equivalent to 2.5 metabolic equivalent tasks (METs), e.g., those who report walking outside vs. those who do not] had 15% and 11% lower risks of developing depression and anxiety, respectively, compared to physically inactive patients
OR = Odds ratio, RR = risk ratio, AOR = adjusted odds ratio, HR = hazard ratio, COPD = pulmonary obstructive chronic disease, PA = physical activity, CI = confidence intervals.