Psychiatric comorbidities in patients with interstitial lung diseases: A narrative review of epidemiology, clinical impact, and integrated care strategies

Abstract

Interstitial lung diseases (ILDs) represent a group of chronic respiratory diseases characterized by inflammation and/or fibrosis of the lung parenchyma with poor prognosis and high mortality. Psychiatric comorbidities, particularly anxiety and depression, are common in patients with ILDs but are frequently underestimated. In this review, we summarize the most current evidence demonstrating that psychiatric comorbidities are prevalent across various ILD subtypes. The coexistence of ILDs and psychiatric comorbidities is associated with a complex interplay of factors, including disease-related symptoms, functional disability, psychosocial stressors, treatment-related factors and potential biological factors involving chronic hypoxia and genetic susceptibility. The presence of anxiety or depression is correlated with worse symptoms, reduced physical activity and impaired health-related quality of life. Despite this, validated, ILD-specific screening tools for psychiatric comorbidity remain inadequate. Furthermore, this review discusses the efficacy and limitations of both pharmacological and non-pharmacological interventions in ILD patients with psychiatric comorbidities. Future studies should focus on the development of standardized assessment tools and the establishment of integrated and personalized management protocols using larger longitudinal studies with diverse ILD populations.