title: The prevalence of posttraumatic stress disorder in patients undergoing pulmonary rehabilitation and changes in PTSD symptoms following rehabilitation.
abstract: OBJECTIVE
  Posttraumatic stress disorder (PTSD) is a common serious condition, which, although treatable, is often undetected. We investigated the prevalence of PTSD in patients with chronic obstructive pulmonary disease (COPD) referred to pulmonary rehabilitation and the impact of rehabilitation on PTSD symptoms.
  
  
  METHODS
  Patients with COPD attending pulmonary rehabilitation programs in South West England completed cross-sectional and longitudinal surveys. Outcome measures included the Posttraumatic Diagnostic Scale, Impact of Events scale, Incremental Shuttle Walking Test, Medical Outcomes Short Form 12, Hospital Anxiety and Depression scale (HADS), and Chronic Respiratory Questionnaire. Questionnaires were completed at face-to-face interviews with participants 1 week before commencing pulmonary rehabilitation and at the end of the program.
  
  
  RESULTS
  Patients (N = 100), mean age 68 years, 65% men, served as subjects. Seventy-four participants reported traumatic experiences (37 related to lung disease) and 70 completed the pulmonary rehabilitation program. Eight of 100 participants met diagnostic criteria for PTSD. Participants with PTSD reported worse health status than those without PTSD. After pulmonary rehabilitation, exercise capacity and quality of life scores improved significantly, but PTSD symptom severity did not change.
  
  
  CONCLUSIONS
  PTSD was present in 8% of COPD patients referred for pulmonary rehabilitation. After rehabilitation, participants with PTSD improved more in respect to anxiety and disease-specific health status than those without PTSD. PTSD symptoms did not improve following rehabilitation, despite its positive effects on HADS scores, exercise, and health status in this cohort.
authors.affiliation: Respiratory Research Unit, Peninsula Medical School, Plymouth, England, UK. rupert.jones@pms.ac.uk
authors.forename: Rupert C M
authors.initials: RC
authors.lastname: Jones
authors.forename: Sam A
authors.initials: SA
authors.lastname: Harding
authors.forename: Man Cheung
authors.initials: MC
authors.lastname: Chung
authors.forename: John
authors.initials: J
authors.lastname: Campbell
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology