Chronic obstructive pulmonary disease affects 13% of older women and 17% of older men in the United States, and is the fourth leading cause of death. Approximately 30% of patients with COPD have depressive disorders, including 20% with major depression, a comorbid condition that contributes to poor treatment adherence, personal suffering, suicidal ideation, functional impairment, excess medical morbidity, and increased use of healthcare services. The assessment of patients with COPD and depression should be comprehensive and include diagnosis and treatment of comorbid psychiatric and medical disorders and inquiry about adverse drug effects. Improving the effectiveness of antidepressant treatment in COPD has the potential to reduce symptoms of depression and improve quality of life, interpersonal relationships, and overall physical comfort. The treatment of the depressed patient with COPD must be comprehensive and directed both to patients and their physicians so that anti-depressant treatment and patient adherence to treatment are optimized.
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