Specific characteristics of psycho-emotional disorders in patients with chronic obstructive pulmonary disease and different clinical phenotypes: review of clinical cases by the results of personal investigations

Actuality. Today chronic obstructive pulmonary disease (COPD) is an urgent medical and social problem leading to the affection not only respiratory system but also other body systems and having a great influence on psychoemotional state of patients and the course of the disease. The most common comorbidities in COPD are cardio-vascular diseases, dysfunction of skeletal muscles, osteoporosis, metabolic syndrome, diabetes mellitus, lung cancer, sleep apnea syndrome and depression. Prevalence of depression among the patients with COPD is considerably higher than in general population. Often thoughts of possible disability lead to pre-depression states which have asymptomatic course and are insufficiently studied. Aim. To evaluate the course of COPD by means of personal observations on the basis of available knowledge about the prevalence and types of somatopsychic disorders. Results. Comorbid psycho-emotional disorders may be considered as one of the factors leading to inadequate control of the disease. Patients with COPD have significantly higher prevalence of concomitant somatopsychic syndromes in comparison with normal persons: high level of neurotization was found in 34 (79,0 %) versus 3 patients (14,3 %), high level of reactive anxiety – in 18 (41,8 %) versus 5 patients (23,8 %) , personal anxiety – in 33 (76,7 %) versus 6 patients (28,6 %), depressive states were diagnosed in 10 (23,2 %) versus 1 case (4,7 %) in the control group (р < 0,001). The prevalence of psycho-emotional disorders was found to depend on the severity of COPD which correlates with the findings of foreign authors. The review of clinical cases showed the course of the disease to be associated with the severity of clinically significant somatopsychic disorders, leading to more unfavorable prognosis for the patient. Conclusions. Prevalence of concomitant psychoemotional disorders in patients with COPD is significantly higher than in healthy persons, they depending on severity of the disease. Comparison of clinical cases of patients with COPD associated with psychoemotional states showed that the presence of clinically evident somatopsychic disorders worsens the course of the disease and the prognosis for the patient.