Toward holistic COPD management: the case for mental health integration

Background and Aims
Chronic obstructive pulmonary disease (COPD) is a growing global public health concern, not only due to its physical effects but also because of the significant psychological distress it causes, including anxiety and depression. This perspective stresses the importance of addressing mental health issues in the management of COPD, discussing current treatment options, which include non-pharmacological interventions.

Methods
This perspective synthesizes current literature on psychological distress in COPD and reviews evidence for non-pharmacological approaches, including pulmonary rehabilitation, cognitive behavioral therapy, self-management programs, telerehabilitation, education, and peer support. It draws on recent literature and guidelines to identify gaps and opportunities for integrated care.

Results
Individuals with COPD experience substantially higher rates of anxiety and depression compared to the general population, and this can negatively impact quality of life, disease progression, and healthcare outcomes. Despite this, mental health symptoms often remain undiagnosed and untreated due to limited awareness, training, and resources. Psychological and non-pharmacological interventions reveal encouraging results in reducing distress and improving overall well-being. Pulmonary rehabilitation, combined with psychological support, demonstrates particular benefits but is underutilized due to patient and systemic barriers. Alternative approaches such as telerehabilitation and remote therapies offer potential for increased access. Moreover, education and peer support play a crucial role in empowering patients, improving coping skills, and fostering social connectedness, which contribute positively to psychological well-being. This perspective advocates for integrated COPD management, which prioritizes mental health literacy, collaborative care models, and patient engagement.

Conclusion
Addressing both the physical and psychological aspects of COPD is essential for holistic care and enhancing the quality of life of individuals with COPD. Further research and healthcare policy efforts are needed to close existing gaps and deliver comprehensive support for people living with COPD.