Comorbid depression and autonomic dysfunction reduce lung function in patients with chronic obstructive pulmonary disease

The high comorbidity rates of depression and chronic obstructive pulmonary disease (COPD) have garnered widespread attention. As a refractory disease, its long-term stress effects exacerbate the coexistence of depression. Depression is linked to a decline in lung function in patients with COPD through reduced heart rate variability, increased inflammatory cytokines, dysregulation of the hypothalamic-pituitary-adrenal axis, and the interplay of various biological and psychological factors. Sole reliance on biomedical treatment cannot fully counteract these negative effects, which are detrimental to improving patients' quality of life and long-term prognosis. Antidepressant medications and traditional Chinese medicine combined with conventional COPD therapy, psychotherapy (<i>e.g.</i>, cognitive behavioral therapy, mindfulness training), and lifestyle adjustments (<i>e.g.</i>, yoga, qigong, or walking) can not only alleviate depression and compensate for the limitations of biomedical approaches but also help improve heart rate variability and lung function. In this editorial, we suggest that clinicians, when prescribing antidepressants, must carefully weigh the benefit-risk ratio based on the patient's specific physical condition to ensure precise medication use.