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

Arch Phys Med Rehabil. 2003 Aug;84(8):1154-7. doi: 10.1016/s0003-9993(03)00239-9.


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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Anxiety / etiology
  • Anxiety / rehabilitation*
  • Depression / etiology
  • Depression / rehabilitation*
  • Exercise Test / methods
  • Exercise Therapy / methods
  • Exercise Tolerance
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Psychotherapy / methods*
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Single-Blind Method
  • Treatment Outcome