title: Psychological outcomes of an outpatient pulmonary rehabilitation program in patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  The effects of an outpatient pulmonary rehabilitation program on psychological morbidity (anxiety and depressive symptoms) were examined in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  The 26 rehabilitation patients with COPD were compared with 19 control patients with COPD similar in age, gender, COPD severity and other variables. Initial assessment included lung function testing, health status, exercise tolerance, dyspnea intensity and psychiatric interviews using Hamilton depression rating scale (HAM-D) and Hamilton anxiety rating scale (HAM-A). A pulmonary rehabilitation program was carried out during the following 2 months; psychiatric interviews and measurements of health status, exercise tolerance and dyspnea intensity were done again on completion of the study at 2 months.
  
  
  RESULTS
  There was a decrease in HAM-A scores in the rehabilitation group and the decrease was statistically significant (P=0.010). On the contrary the HAM-A scores did not change in control group. The decrease in HAM-A scores in rehabilitation group was also statistically significant compared with the control group (P=0.042). There was no significant difference in HAM-D scores within the two groups and also there was no significant difference between the two groups in HAM-D scores. The health status, exercise tolerance and dyspnea intensity improved significantly in the rehabilitation group compared to the control group.
  
  
  CONCLUSIONS
  This study shows that our outpatient rehabilitation program leads to a benefit in anxiety and depressive symptoms in COPD patients. The benefit was especially significant in anxiety symptoms. In addition to the improvement in psychological symptoms, the health status, exercise tolerance and dyspnea intensity were also significantly improved in COPD patients who underwent the rehabilitation program. This outpatient-based rehabilitation program was well accepted by the patients. The relatively simple design of the program makes it feasible independently of expensive equipment.
authors.affiliation: Department of Psychiatry, School of Medicine, Ege University, 35100 Bornova, Izmir, Turkey. bkayahan@yahoo.com
authors.forename: Bülent
authors.initials: B
authors.lastname: Kayahan
authors.forename: Hale
authors.initials: H
authors.lastname: Karapolat
authors.forename: Ender
authors.initials: E
authors.lastname: Atýntoprak
authors.forename: Alev
authors.initials: A
authors.lastname: Atasever
authors.forename: Ozgür
authors.initials: O
authors.lastname: Oztürk
mesh_terms: D000368:Aged; D001007:Anxiety / Q000503:physiopathology / Q000628:therapy*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003863:Depression / Q000503:physiopathology / Q000628:therapy*; D017079:Exercise Tolerance; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D012129:Respiratory Function Tests