title: Cognitive behaviour therapy reduces dyspnoea ratings in patients with chronic obstructive pulmonary disease (COPD).
abstract: There is evidence that psychological factors contribute to the perception of increased difficulty of breathing in patients with chronic obstructive pulmonary disease (COPD), and increase morbidity. We tested the hypothesis that cognitive behaviour therapy (CBT) decreases ratings of perceived dyspnoea in response to resistive loading in patients with COPD. From 31 patients with COPD, 18 were randomised to four sessions of specifically targeted CBT and 13 to routine care. Prior to randomisation, participants were tested with an inspiratory external resistive load protocol (loads between 5 and 45cmH2O/L/s). Six months later, we re-measured perceived dyspnoea in response to the same inspiratory resistive loads and compared results to measurements prior to randomisation. There was a significant 17% reduction in dyspnoea ratings across the loads for the CBT group, and no reduction for the routine care group. The decrease in ratings of dyspnoea suggests that CBT to alleviate breathing discomfort may have a role in the routine treatment of people with COPD.
authors.affiliation: Department of Liaison Psychiatry, Prince of Wales Hospital, Sydney, Australia; Department of Psychology, University of Sydney, Sydney, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Livermore
authors.affiliation: Department of Respiratory Medicine, Prince of Wales Hospital, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Dimitri
authors.affiliation: Department of Psychology, University of Sydney, Sydney, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Sharpe
authors.affiliation: Department of Respiratory Medicine, Prince of Wales Hospital, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors.forename: David K
authors.initials: DK
authors.lastname: McKenzie
authors.affiliation: Department of Neurology, Prince of Wales Hospital, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Simon C
authors.initials: SC
authors.lastname: Gandevia
authors.affiliation: Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia. Electronic address: j.butler@neura.edu.au.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Butler
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology / Q000534:rehabilitation; D001945:Breathing Exercises; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000534:rehabilitation; D004417:Dyspnea / Q000209:etiology* / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D016896:Treatment Outcome
keywords: Chronic obstructive pulmonary disease; Cognitive behaviour therapy; Dyspnoea; Inspiratory resistive loads