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Statement of the Problem: Chronic diseases like pulmonary
ones include wide range of diseases and so diverse areas. They
need psychiatric and psychological services, 10 times more than
people who do not suffer chronic diseases.
Materials & Methods: In the current study, we investigated
psychological status and severity and pattern of substance use in
531 chronic pulmonary patients with tuberculosis, asthma, chronic
obstructive pulmonary disease (COPD) and lung transplantation
patients in a prospective study in eight months.
Findings: Our results showed that the percentage of male gender
was more between tubercular, lung transplantation and COPD
patients, but the number of women was more just between
asthmatic patients. The average age of COPD patients was more
than other patients, which was 66 years old. The number of single
patients was more between lung transplantation patients, and
67% of them were single. The number of married patients was
the most between asthmatic patients and 83% of them were
married. Four per cent of the patients used guarded contact.
Two per cent of men used manipulative contact, which was not
used by women. Sixty eight per cent of the patients suffered from
depression. Obsession was one of the symptoms in content of
thought that existed in 25% of the patients, mostly in women.
Thirteen per cent of patients had suicide ideation, which most
of them were men. Hopelessness thoughts were more common
between men. Eighty two per cent were irritable. Thirteen per cent
had attempted suicide. Thirteen per cent had visual hallucinations
and 12.5% had auditory hallucinations which were more common
between men. In the field of physiology, 59% of women and 60% of
men suffered insomnia. Hundred per cent of transplantation and
tubercular patients had used cigarettes and 68% of them smoked
daily at the time of the research. Forty per cent of COPD patients
smoked more than 30 cigarettes per day. Fifty one per cent of
COPD patients smoked cigarettes until five minutes after waking
up. Eighty three per cent of asthmatic patients had attempted to
quit smoking.
Conclusion: All in all, results of the current study showed
that a large number of patients use cigarettes and opium and
suffer psychiatric disorders, despite their advanced pulmonary
disease. This issue results in reduced treatment compliance
and also increased number of hospitalizations. Undoubtedly,
careful planning should be done for simultaneous treatment of
pulmonary, psychiatric and substance induced diseases of these
patients. The holistic treatment requires considering the patient
as a human, not just as a patient lung and understanding the
point that the optimal treatment would not be reached, unless we
simultaneously treat physical and psychological problems of the
patients.
Biography
Mitrasafa is a Professor, Psychiatrist, Head of psychiatry unit, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Science, Tehran, Iran.Member of the examining committee of sleep fellowship students National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Science, Tehran, Iran, since 2015.President of professional ethics and manner and communicational skills committee of Educational Development Unit(EDU) of National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Science, Tehran, Iran, since 2015. President of female committee in National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Science, Tehran,Iran, since 2011 .Member of establishing committee of Clinical Tuberculosis and Epidemiology Research Center since 2009. Permanent member of Iranian Stop TB committee(TBC) since 2009.