Respiratory Medicine
Volume 104, Issue 7 , Pages 986-994, July 2010

A randomized controlled trial of cognitive behavioral therapy for anxiety and depression in COPD

  • Minna J. Hynninen

      Affiliations

    • Department of Clinical Psychology, University of Bergen, Christies gt 12, N-5015 Bergen, Norway
    • Corresponding Author InformationCorresponding author. Tel.: +47 55 58 88 96; fax: +47 55 58 98 77.
    • ,
  • Nina Bjerke

      Affiliations

    • Department of Clinical Psychology, University of Bergen, Christies gt 12, N-5015 Bergen, Norway
    • ,
  • Ståle Pallesen

      Affiliations

    • Department of Clinical Psychology, University of Bergen, Christies gt 12, N-5015 Bergen, Norway
    • ,
  • Per S. Bakke

      Affiliations

    • Institute of Medicine, University of Bergen, Haukeland University Hospital, N-5021 Bergen, Norway
    • Department of Thoracic Medicine, Haukeland University Hospital, N-5021 Bergen, Norway
    • ,
  • Inger Hilde Nordhus

      Affiliations

    • Department of Clinical Psychology, University of Bergen, Christies gt 12, N-5015 Bergen, Norway

Received 1 October 2009; accepted 22 February 2010. published online 29 March 2010.

Summary 

Background

Previous research indicates a high prevalence of untreated anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). The current study examined the effect of cognitive behavioral therapy (CBT) in groups for co-morbid, clinically significant anxiety and depression in COPD outpatients of both sexes.

Methods

In a randomized, controlled trial, CBT (n = 25) was compared with enhanced standard care (n = 26). Participants in both conditions were followed up at 2 and 8 months from baseline. Main outcome measures comprised the Beck Anxiety Inventory and the Beck Depression Inventory-II. Measures of health status and sleep were included as secondary outcomes. The effects of sex and age were also investigated.

Results

CBT resulted in improvement in symptoms of anxiety and depression, with effect sizes of 1.1 and 0.9 at post-treatment, respectively. The improvement was maintained at the 8-month follow-up, with effect sizes of 1.4 and 0.9. In the control group, there was no significant change. Compared to men, women had higher symptom levels throughout the whole study period. Younger patients had more anxiety and depression, age had also differential effects in the two groups on change in depressive symptoms. Changes in sleep and health status were small in both groups.

Conclusions

The findings indicate that CBT may provide rapid symptom relief for COPD patients with clinically significant anxiety and depression, and underline the need for integrating mental health care into the overall medical regimen for COPD.

Keywords: COPD, Cognitive behavioral therapy, Anxiety, Depression, Psychological

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PII: S0954-6111(10)00090-9

doi:10.1016/j.rmed.2010.02.020

Respiratory Medicine
Volume 104, Issue 7 , Pages 986-994, July 2010

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