Mental Health Shows Associations With COPD Outcomes

Investigators found that severe chronic obstructive pulmonary disease was associated with increased psychological distress, reduced self-esteem, and reliance on avoidant coping mechanisms. Additionally, the authors stated that higher self-esteem and better functional capacity pointed towards adaptive coping strategies.¹

“The primary goal of this study was to explore the coping strategies employed by patients with moderate and severe COPD and to analyze how these are related to psychological health, disease impact, and functional ability,” the study authors wrote in the study.¹ “Previous research from our group has shown that COPD severity is associated with self-conscious emotions such as guilt and shame, as well as with self-compassion and self-efficacy.”

The American Lung Association said that the physical challenges of managing COPD can affect a patient’s mood and emotional health, such as increasing the feelings of sadness, fear, and worry. The organization also stated that anxiety and depression often go unrecognized and untreated, which can affect a patient’s COPD treatment plan, physical health, and medical costs.²

In a review published in Advances in Respiratory Medicine, the authors stated that patients with COPD with comorbid anxiety or depression tend to experience more acute exacerbations, incidences of rehospitalization, and a higher risk of mortality. They added that ongoing investigations would benefit from focusing on screening, diagnosis, and management of COPD, anxiety, and depression.³

In the current study published in the International Journal of Chronic Obstructive Pulmonary Disease, the authors investigated various coping patterns associated with psychological status, symptom severity, and functional capacity in association with moderate and severe COPD. Patients were included if they were 40 years or older with a confirmed diagnosis of COPD.¹

There were 93 patients included, with 43 having moderate COPD and 50 having severe COPD. Patients who had severe COPD had higher symptom burden, more comorbidities, higher anxiety, and more psychological distress compared with patients who had moderate COPD. Further, patients with severe COPD had reductions in problem- and emotion-focused strategies and relied on avoidant coping. For coping mechanisms focused on problem solving, investigators found that these were associated with healthier clinical profiles, lower anxiety, lower psychological distress, higher self-esteem, better exercise performance, and better lung function.¹

The authors stated that emotion-focused coping also had similar positive patterns for functional capacity, higher self-esteem, and reduced symptom burden and dyspnea. However, for avoidant coping mechanisms, investors noted that there were less favorable profiles for symptoms, self-esteem, lung function, and poorer performance on the 6-minute walking test.¹

“Problem-focused and emotion-focused coping showed positive correlations with preserved lung function (FEV1%, FVC%), greater functional capacity (6MWT m and 6MWT%), and higher self-esteem, whereas avoidant-focused coping correlated with greater dyspnea severity (mMRC), higher symptom burden (CAT), and reduced exercise capacity,” the study authors said.¹ “Future research should further investigate how self-esteem and coping strategies interact with disease impact and functional capacity in COPD.”

READ MORE: Respiratory Resource Center

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REFERENCES

1. Pescaru CC, Crisan AF, Maritescu A, Tudorache E, Oancea C. A Multidimensional Perspective on COPD: How Coping Styles and Self-Esteem Relate to Psychological Distress and Functional Capacity. Int J Chron Obstruct Pulmon Dis. 2025 Dec 27;20:4143-4157. doi: 10.2147/COPD.S561817. PMID: 41479672; PMCID: PMC12755091.

2. American Lung Association. COPD and Emotional Health. Updated November 21, 2025. Accessed January 6, 2026. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/living-with-copd/coping-with-emotions

3. Rahi MS, Thilagar B, Balaji S, et al. The Impact of Anxiety and Depression in Chronic Obstructive Pulmonary Disease. Adv Respir Med. 2023;91(2):123-134. Published 2023 Mar 10. doi:10.3390/arm91020011