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COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial.
Psychol Med 2008; 38(3):385-96PM

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) affects 14 to 20 million Americans and is associated with increased prevalence of affective disorders, contributing significantly to disability. This study compared cognitive behavioral therapy (CBT) group treatment for anxiety and depression with COPD education for COPD patients with moderate-to-severe anxiety and/or depressive symptoms.

METHOD

A randomized controlled trial (RCT) was conducted between 11 July 2002 and 30 April 2005 at the Michael E. DeBakey VA Medical Center, Houston, TX. Participants were 238 patients treated for COPD the year before, with forced expiratory value in 1 second (FEV)1/forced vital capacity (FVC)<70% and FEV1<70% predicted, and symptoms of moderate anxiety and/or moderate depression, who were being treated by a primary care provider or pulmonologist. Participants attended eight sessions of CBT or COPD education. Assessments were at baseline, at 4 and 8 weeks, and 4, 8 and 12 months. Primary outcomes were disease-specific and generic quality of life (QoL) [Chronic Respiratory Questionnaire (CRQ) and Medical Outcomes Survey Short Form-36 (SF-36) respectively]. Secondary outcomes were anxiety [Beck Anxiety Inventory (BAI)], depressive symptoms [Beck Depression Inventory-II (BDI-II)], 6-minute walk distance (6MWD) and use of health services.

RESULTS

Both treatments significantly improved QoL, anxiety and depression (p<0.005) over 8 weeks; the rate of change did not differ between groups. Improvements were maintained with no significant change during follow-up. Ratios of post- to pretreatment use of health services were equal to 1 for both groups.

CONCLUSIONS

CBT group treatment and COPD education can achieve sustainable improvements in QoL for COPD patients experiencing moderate-to-severe symptoms of depression or anxiety.

Authors+Show Affiliations

Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Houston, TX 77030, USA. mkunik@bcm.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

17922939

Citation

Kunik, M E., et al. "COPD Education and Cognitive Behavioral Therapy Group Treatment for Clinically Significant Symptoms of Depression and Anxiety in COPD Patients: a Randomized Controlled Trial." Psychological Medicine, vol. 38, no. 3, 2008, pp. 385-96.
Kunik ME, Veazey C, Cully JA, et al. COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychol Med. 2008;38(3):385-96.
Kunik, M. E., Veazey, C., Cully, J. A., Souchek, J., Graham, D. P., Hopko, D., ... Stanley, M. A. (2008). COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychological Medicine, 38(3), pp. 385-96.
Kunik ME, et al. COPD Education and Cognitive Behavioral Therapy Group Treatment for Clinically Significant Symptoms of Depression and Anxiety in COPD Patients: a Randomized Controlled Trial. Psychol Med. 2008;38(3):385-96. PubMed PMID: 17922939.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. AU - Kunik,M E, AU - Veazey,C, AU - Cully,J A, AU - Souchek,J, AU - Graham,D P, AU - Hopko,D, AU - Carter,R, AU - Sharafkhaneh,A, AU - Goepfert,E J, AU - Wray,N, AU - Stanley,M A, Y1 - 2007/10/09/ PY - 2007/10/10/pubmed PY - 2008/5/6/medline PY - 2007/10/10/entrez SP - 385 EP - 96 JF - Psychological medicine JO - Psychol Med VL - 38 IS - 3 N2 - BACKGROUND: Chronic obstructive pulmonary disease (COPD) affects 14 to 20 million Americans and is associated with increased prevalence of affective disorders, contributing significantly to disability. This study compared cognitive behavioral therapy (CBT) group treatment for anxiety and depression with COPD education for COPD patients with moderate-to-severe anxiety and/or depressive symptoms. METHOD: A randomized controlled trial (RCT) was conducted between 11 July 2002 and 30 April 2005 at the Michael E. DeBakey VA Medical Center, Houston, TX. Participants were 238 patients treated for COPD the year before, with forced expiratory value in 1 second (FEV)1/forced vital capacity (FVC)<70% and FEV1<70% predicted, and symptoms of moderate anxiety and/or moderate depression, who were being treated by a primary care provider or pulmonologist. Participants attended eight sessions of CBT or COPD education. Assessments were at baseline, at 4 and 8 weeks, and 4, 8 and 12 months. Primary outcomes were disease-specific and generic quality of life (QoL) [Chronic Respiratory Questionnaire (CRQ) and Medical Outcomes Survey Short Form-36 (SF-36) respectively]. Secondary outcomes were anxiety [Beck Anxiety Inventory (BAI)], depressive symptoms [Beck Depression Inventory-II (BDI-II)], 6-minute walk distance (6MWD) and use of health services. RESULTS: Both treatments significantly improved QoL, anxiety and depression (p<0.005) over 8 weeks; the rate of change did not differ between groups. Improvements were maintained with no significant change during follow-up. Ratios of post- to pretreatment use of health services were equal to 1 for both groups. CONCLUSIONS: CBT group treatment and COPD education can achieve sustainable improvements in QoL for COPD patients experiencing moderate-to-severe symptoms of depression or anxiety. SN - 0033-2917 UR - https://www.unboundmedicine.com/medline/citation/17922939/COPD_education_and_cognitive_behavioral_therapy_group_treatment_for_clinically_significant_symptoms_of_depression_and_anxiety_in_COPD_patients:_a_randomized_controlled_trial_ L2 - https://www.cambridge.org/core/product/identifier/S0033291707001687/type/journal_article DB - PRIME DP - Unbound Medicine ER -