Those with COPD are more likely to have anxiety, depression, or another psychiatric disorder than people in the general population. Women with COPD are more susceptible to psychological problems than men.

If patients with COPD become anxious or depressed, they may have a poorer outlook than people without emotional problems. Depression and anxiety are associated with an increase in the frequency and length of exacerbations, as well as the number of hospitalizations. Having anxiety can cause exacerbations to last twice as long as they would otherwise. Depression also increases the risk of death in both those with stable COPD and in those with uncontrolled disease. Having depression may prevent people with COPD from eating properly, exercising, taking their medication as prescribed, and getting the medical attention they need.

Low oxygen levels also can impair mental function and short-term memory. Psychological therapy may be particularly helpful for people with COPD.

Malnourishment

People with COPD often lack good nutrition. Patients with chronic bronchitis tend to be obese. Patients with emphysema tend to be underweight. Loss of weight and muscle mass is linked to a poor outcome in COPD. Good nutrition improves the ability to exercise, which in turn builds muscle strength and lung function. Obese patients with COPD who lose weight tend to sleep better.

Heart Disease

Over time, COPD causes low levels of oxygen (hypoxia) and high levels of carbon dioxide (hypercapnia) in the body. In order to boost oxygen delivery, the body compensates in a number of ways:

• Blood vessels in the lung narrow. This leads to high blood pressure in the lungs (pulmonary hypertension).
• More red blood cells are produced to increase the blood's ability to carry oxygen.
• The heart rate increases to pump more blood.
• The breathing rate increases.

Eventually these activities can lead to very serious and even life-threatening conditions:

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Review Date: 04/10/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)