Abdulkader Alam, MD Assistant Professor of Psychiatry and Internal Medicine Department of Psychiatry and Internal Medicine Stony Brook University School of Medicine Stony Brook, New York
R. Michael Huijon, MD Resident, Combined Psychiatry and Family Medicine University of Pittsburgh Pittsburgh, Pennsylvania
Vijaya Alla, MD Resident Family Medicine Stony Brook University School of Medicine Stony Brook, New York
Nicole Rivera, BS Medical Student Stony Brook University School of Medicine Stony Brook, New York
You can do a great deal to ease patients’ pulmonary distress as you manage their psychiatric illness.
Referral to a pulmonologist is strongly advised in cases of:
advanced, end-stage COPD (FEV1 <50% predicted value despite adherence to recommended treatment, or rapid decline of FEV1)
COPD in patients age <50
frequent exacerbations
possible complications related to chronic heart failure
indications for oxygen treatment (eg, resting or ambulatory oxygen saturation ≤88% or PaO2 ≤55 mm Hg).32
Bottom Line Chronic obstructive pulmonary disease (COPD) is a common condition with high morbidity and mortality. Comorbid COPD and tobacco smoking is especially prevalent in people with mental illness. Early diagnosis of COPD is important because appropriate management can alleviate symptoms, improve health status and exercise capacity, and prolong survival. You can play an integral role in COPD management by promoting smoking cessation and encouraging adherence to treatment.
Related Resources
Agency for Healthcare Research and Quality. Help for smokers and other tobacco users: quit smoking. www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/tearsheets/helpsmokers.html.
Mayo Clinic. Diseases and conditions: COPD. www.mayoclinic.com/health/copd/DS00916.
Criner GJ, Bourbeau J, Diekemper RL, et al. Prevention of acute exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest. 2015;147(4):894-942.
Global Initiative for Chronic Obstructive Lung Disease. Guidelines for professionals in the diagnosis and treatment of COPD. www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html.
Disclosures The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
