title: Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD.
abstract: OBJECTIVE
  To determine the impact of an 8-wk program of comprehensive pulmonary rehabilitation on depression, anxiety, dyspnea, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  We studied 24 patients with severe COPD randomized either to pulmonary rehabilitation (PR), (n = 10; FEV1 30 +/- 9%) or control (C; n = 14; FEV1 34 +/- 11%). The PR program included disease education, energy conservation techniques, relaxation, and exercise including 20-min arm elevation with dumbbells and 20-min leg exercise sessions three times a week for 8 wks. At baseline and after completion of the program, all patients were evaluated using the Beck Depression Inventory, State Trait Anxiety Inventory (STAI), Modified Medical Research Council Scale (MRC), and St. George's Respiratory Questionnaire (SGRQ).
  
  
  RESULTS
  After PR, there was a significant improvement in the severity of depression (P < 0.01), a decrease in symptoms (P < 0.05), an increase in daily living activities (P < 0.05), and a decrease in the total score of the SGRO (P < 0.01). Dyspnea measured by the MRC scale was significantly better in the PR group (P < 0.01).
  
  
  CONCLUSIONS
  The present study shows that in patients with severe COPD, pulmonary rehabilitation induces important changes on depression and anxiety independent of changes in dyspnea and health-related quality-of-life.
authors.affiliation: Pulmonary Division, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: Hildegarde
authors.initials: H
authors.lastname: Paz-Díaz
authors.forename: Maria
authors.initials: M
authors.lastname: Montes de Oca
authors.forename: Jose M
authors.initials: JM
authors.lastname: López
authors.forename: Bartolome R
authors.initials: BR
authors.lastname: Celli
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D018434:Sickness Impact Profile; D013147:Spirometry; D011795:Surveys and Questionnaires; D014891:Weight Lifting