A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease

Abstract

Objective: To assess the effect of psychotherapy on the anxiety and depression levels of patients with chronic obstructive pulmonary disease (COPD).

Design: A blind, randomized, controlled trial.

Setting: Outpatient university pulmonary rehabilitation program in Brazil.

Participants: Thirty patients with COPD (mean age, 60.33y; 22 men) attending a pulmonary rehabilitation program were randomized into 2 groups: experimental group (G1) and control group (G2). Both groups underwent a 12-week treatment program.

Interventions: Group 1 (n=14) participated in 24 sessions of physical exercise, 24 sessions of physiotherapy, 12 psychologic sessions, and 3 educational sessions. Group 2 did not participate in psychotherapy sessions.

Main outcome measures: All patients were evaluated at baseline and at completion of the pulmonary rehabilitation program by using 3 instruments: the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and 6-minute walk distance (6MWD).

Results: Both groups showed statistically significant improvements on the 6MWD (G1, P<.001; G2, P=.03). Only G1 had a significant reduction in anxiety and depression levels (G1: BAI, P<.001; BDI, P<.001; G2: BAI, P=.156; BDI, P=.142). Statistically significant differences existed between G1 and G2 for BAI (P<.001) and BDI (P=.02).

Conclusions: Including psychotherapy in a pulmonary rehabilitation program for COPD reduced patients' anxiety and depression levels but did not modify 6MWD performance.