PMID- 17922939
OWN - NLM
STAT- MEDLINE
DCOM- 20080505
LR  - 20181201
IS  - 0033-2917 (Print)
IS  - 0033-2917 (Linking)
VI  - 38
IP  - 3
DP  - 2008 Mar
TI  - COPD education and cognitive behavioral therapy group treatment for clinically 
      significant symptoms of depression and anxiety in COPD patients: a randomized 
      controlled trial.
PG  - 385-96
AB  - 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.
FAU - Kunik, M E
AU  - Kunik ME
AD  - Houston Center for Quality of Care and Utilization Studies, Health Services 
      Research and Development Service, Houston, TX 77030, USA. mkunik@bcm.tmc.edu
FAU - Veazey, C
AU  - Veazey C
FAU - Cully, J A
AU  - Cully JA
FAU - Souchek, J
AU  - Souchek J
FAU - Graham, D P
AU  - Graham DP
FAU - Hopko, D
AU  - Hopko D
FAU - Carter, R
AU  - Carter R
FAU - Sharafkhaneh, A
AU  - Sharafkhaneh A
FAU - Goepfert, E J
AU  - Goepfert EJ
FAU - Wray, N
AU  - Wray N
FAU - Stanley, M A
AU  - Stanley MA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20071009
PL  - England
TA  - Psychol Med
JT  - Psychological medicine
JID - 1254142
SB  - IM
MH  - Aged
MH  - Anxiety Disorders/diagnosis/epidemiology/*therapy
MH  - Cognitive Behavioral Therapy/*methods
MH  - Comorbidity
MH  - Depressive Disorder/diagnosis/epidemiology/*therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Health Services/statistics & numerical data
MH  - Health Status
MH  - Humans
MH  - Male
MH  - Patient Education as Topic/*methods
MH  - Personality Inventory
MH  - Psychotherapy, Group/methods
MH  - Pulmonary Disease, Chronic Obstructive/epidemiology/*psychology/therapy
MH  - Quality of Life
MH  - Surveys and Questionnaires
MH  - Texas/epidemiology
MH  - Treatment Outcome
EDAT- 2007/10/10 09:00
MHDA- 2008/05/06 09:00
CRDT- 2007/10/10 09:00
PHST- 2007/10/10 09:00 [pubmed]
PHST- 2008/05/06 09:00 [medline]
PHST- 2007/10/10 09:00 [entrez]
AID - S0033291707001687 [pii]
AID - 10.1017/S0033291707001687 [doi]
PST - ppublish
SO  - Psychol Med. 2008 Mar;38(3):385-96. doi: 10.1017/S0033291707001687. Epub 2007 Oct 
      9.