Psychological distress is prevalent in people with COPD and relates to a worse course of disease. It often remains unrecognised and untreated, intensifying the burden on patients, carers and healthcare systems. Nonpharmacological management strategies have been suggested as important elements to manage psychological distress in COPD. Therefore, this review presents instruments for detecting psychological distress in COPD and provides an overview of available nonpharmacological management strategies together with available scientific evidence for their presumed benefits in COPD. Several instruments are available for detecting psychological distress in COPD, including simple questions, questionnaires and clinical diagnostic interviews, but their implementation in clinical practice is limited and heterogeneous. Moreover, various nonpharmacological management options are available for COPD, ranging from specific cognitive behavioural therapy (CBT) to multi-component pulmonary rehabilitation (PR) programmes. These interventions vary substantially in their specific content, intensity and duration across studies. Similarly, available evidence regarding their efficacy varies significantly, with the strongest evidence currently for CBT or PR. Further randomised controlled trials are needed with larger, culturally diverse samples and long-term follow-ups. Moreover, effective nonpharmacological interventions should be implemented more in the clinical routine. Respective barriers for patients, caregivers, clinicians, healthcare systems and research need to be overcome.

COPD has a profound impact on the lives of patients and their partners, but the influence on physical, psychological and social aspects of sexual health has not been reviewed systematically. Searches for studies of the impact of COPD on sexual health were conducted independently by two authors in the databases of PubMed, PsycINFO, Embases, CINAHL, Web of Science, Scopus and The Cochrane Library. English-language quantitative and qualitative studies assessing one or more aspects of sexual health in patients diagnosed with COPD were narratively reviewed and, when possible, subjected to meta-analytic evaluation. A total of 31 studies, including 4 qualitative, were included. Twelve studies assessing erectile dysfunction with the International Index of Erectile Function were subjected to meta-analysis. The pooled prevalence of erectile dysfunction was 74% (95% CI: 68– 80%) in a total of 1187 patients with COPD, compared with 56% (37– 73%) in 224 age-matched, non-COPD controls. The sexual health outcomes assessed in the remaining studies varied considerably, compromising the comparability of the results. None of the qualitative studies had sexual health as their primary focus. Compared with non-COPD individuals, erectile dysfunction appears to be more prevalent among patients with COPD, but more studies including non-COPD controls are needed to confirm this finding. In addition, the impact of COPD on other physical, psychological and social aspects of sexual health remains unclear due to the lack of comparable assessment methods and study designs.

Introduction: Smoking cessation support (SCS) in the hospital is essential; patients often struggle to maintain quit attempts, which necessitates assistance from healthcare professionals (HCPs). However, unknown barriers can obstruct the implementation of SCS in hospitals. This study aims to...

Background: Anxiety in patients with chronic obstructive pulmonary disease (COPD) is prevalent but often unidentified and therefore not adequately managed. Clinicians find it difficult to detect anxiety symptoms and to differentiate subclinical anxiety from anxiety disorders, because of the considerable overlap between symptoms of COPD and anxiety. Purpose: We synthesized existing qualitative research on patients’ experiences of COPD-related anxiety with the purpose of gaining a richer understanding and proposing a model of the construct. Methods: Searches for qualitative studies of patients’ experiences of COPD-related anxiety were conducted independently by two authors in the databases of PubMed (MEDLINE), CINAHL (EBSCO), and PsycInfo (APA). English-language studies including patients diagnosed with COPD were reviewed, and data were analyzed using thematic analysis. Results: A total of 41 studies were included in the review. Four themes related to COPD-related anxiety were identified: initial events; internal maintaining factors; external maintaining factors; and behavioral maintaining factors. Based on the identified four themes, a conceptual model of COPD-related anxiety from the patient perspective was developed. Conclusion: A conceptual model of COPD-related anxiety from the patient perspective is now available, with the potential to inform future attempts at improving identification and management of COPD-related anxiety. Future research should focus on the development of a COPD-specific anxiety questionnaire containing domains that are relevant from the patient perspective.

A distinct grief-specific disorder is included in the ICD-11. Lack of clarity remains regarding whether different proposed diagnostic criteria capture similar or different diagnostic entities. Our aim was to examine the specificity of four proposed diagnostic criteria-sets for pathological grief in a population-based sample. Participants were 206 conjugally bereaved elderly Danes (59% female; mean age = 72.5 years, SD = 4.2; range 65-81) who completed self-report questionnaires six months post-loss. The main measure was the Danish version of Inventory of Complicated Grief-Revised. Results indicate substantial agreement between Prolonged Grief Disorder (PGD), Persistent Complex Bereavement Disorder (PCBD) and ICD-11-PGD (kappa's = 0.69-0.84), which found 6-9% of cases tested positive for pathological grief. Complicated Grief (CG) was partly in agreement with the three other symptom-diagnostic tests (kappa's = 0.13-0.20), and the prevalence-rate of pathological grief was 48%. The low response-rate of 39%. The selective inclusion of data ≥6 months post-loss prevents a comparison of acute and prolonged grief reactions. Using self-reported data, not diagnostic interviews, challenges the validity of our findings. Using a sample of elderly people may limit the generalizability of our results to other age groups. We suggest that PGD, PCBD and ICD-11-PGD may be more discriminative in identifying a specific grief-related psychopathology, while CG may identify a broader set of grief reactions.