Anxiety is a relatively common complaint for patients with moderate to severe chronic obstructive pulmonary disease (COPD). The presence of anxiety can identify a patient who may require more aggressive management.


Anxiety may manifest itself as:

(1) a generalized anxiety disorder (GAD)

(2) panic attacks


Risk factors for anxiety in a patient with COPD:

(1) history of an anxiety disorder

(2) feeling no or little control over the disease

(3) past episodes of air hunger causing significant distress

(4) effect of medications (corticosteroids, etc)

(5) other reasons for worry (comorbid conditions, economic problems, etc)

(6) no or little social support

(7) finding self in situations where oxygen or other resources are suddenly lacking

(8) heightened awareness of dyspnea

(9) poor sleep

(10) frequent disease exacerbations


A patient with COPD and one or more of these complaints should be screened for anxiety.


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