Strong link between mood and symptoms in IPF

Treating anxiety and depressive symptoms in patients with idiopathic pulmonary fibrosis (IPF) might be a way of improving physical symptoms such as cough and breathlessness, new research has suggested.

A cross-sectional study of 102 patients from the Australian IPF Registry, found a strong interaction between cough and dyspnea and the presence of anxiety and depression.

Co-author Associate Professor Ian Glaspole, from the department of allergy, immunology and respiratory medicine at the Alfred Hospital, told the limbic the direction of that link was not clear.

“One thing we do know is that we are terrible at palliating symptoms in IPF and we need to find therapies that might ameliorate those symptoms,” he said.

“Recognition of the strong link between mood and symptoms suggests there might be a role for using mood-related therapies to try and palliate symptoms.”

The study found about 14% of patients with IPF had depression and 21% had anxiety.

“What surprised us was that although about one in five patients had these symptoms at baseline, about three quarters of those patients still had them at 12 months.”

“So although it’s not the majority of patients who suffer those symptoms, in the majority of patients who have those symptoms they persist.”

The study also identified significant under-treatment with about one quarter of patients receiving pharmacological therapies for their mood disorders.

“My feeling is that it’s not particularly well recognised. People come in with a disease which is devastating, and I think it would be a natural assumption amongst their carers that they would express anxiety, depression or sadness about their condition.”

Associate Professor Glaspole said it was otherwise not clear why doctors might take a non-therapeutic approach to mood disorders when there were effective treatments including medications and psychological or cognitive therapies.

“Is it that physicians feel that this is what we would expect in somebody with a chronic and progressive disorder with such limited survival?”

He said patients with significant breathlessness and cough should be explored for the coexistent presence of anxiety and depression.

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