Using individualised cognitive behavioural therapy as a treatment for people with COPD.
BACKGROUND
COPD is a common progressive and debilitating medical condition. Mental health difficulties, such as anxiety and depression, have been reported in 25-50% of all patients with COPD. Interventions that reduce anxiety and depressive symptoms may affect COPD outcomes. Little data exists on the effect of managing these psychological difficulties in this group.


METHODS
We studied the effects of a respiratory nurse-led cognitive behavioural therapy programme in 10 patients with COPD, assessing goal achievement, Hospital Anxiety and Depression Scale scores and medical admission rates.


RESULTS
We used CBT in 10 patients with COPD across a range of severities. All 10 patients completed the CBT programme, with an average of four sessions (range 2-13). The mean score in the anxiety domain fell from 10.6 (range 6-15) before CBT to 3.8 after the intervention (range 1-7; p < 0.001). Similar improvements were seen in the depression domain, with a mean score before CBT of 10.9 (range 2-17), falling to a mean score after treatment of 5.2 (range 3-12; p < 0.001). A statistically significant reduction in the number of admissions was seen, with a mean of 1.1 admissions (total 11) before CBT to a mean of 0.2 admissions (total 2), p = 0.02.


CONCLUSIONS
In this non-randomised study, a programme of individualised CBT in patients with COPD resulted in marked improvements in psychosocial impairment and a significant reduction in service use.
Heslop
Karen
K
Royal Victoria Infirmary, Newcastle.
De Soyza
Anthony
A
Baker
Christine R
CR
Stenton
Chris
C
Burns
Graham P
GP
D015928:Cognitive Behavioral Therapy; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012129:Respiratory Function Tests