The most effective psychologically-based treatments to reduce anxiety and panic in patients with chronic obstructive pulmonary disease (COPD): a systematic review

Rose, Christine; Wallace, Louise; Dickson, Rumona; Ayres, Jon G.; Lehman, Richard; Searle, Y.; Burge, P. S.

doi:10.1016/s0738-3991(02)00004-6

Cited by 72 publications

(44 citation statements)

References 34 publications

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“…Therefore, it appears that complex interrelationships between dyspnoea and anxiety contribute to the increased prevalence of anxietyrelated disorders in COPD. Although pathophysiological mechanisms, such as chemoreceptor hypersensitivity to carbon dioxide, have also been proposed to link panic attacks with a heightened experience of dyspnoea in a subgroup of COPD patients [19,36], it is important to note that the magnitude of dyspnoea at rest or on exertion does not correlate with the magnitude of anxiety-related symptoms [37]. Furthermore, it has not been convincingly demonstrated that the magnitude of decrease in dyspnoea with pharmacological therapy or exercise training is associated with the magnitude of reduction in anxiety-related symptoms.…”

Section: Mechanismsmentioning

confidence: 99%

Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

Eur Respir J

230

142

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Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), estimates of their prevalence vary considerably. This probably reflects the variety of scales and methods used to measure such symptoms. Regardless of whether anxiety and depression are considered separately or as a single construct, their impact on COPD patients is important.A heightened experience of dyspnoea is likely to be a contributing factor to anxiety. Feelings of depression may be precipitated by the loss and grief associated with the disability of COPD. Smoking has been associated with nicotine addiction, and the factors that contribute to smoking may also predispose to anxiety and depressive disorders.Randomised controlled trials indicate that exercise training and carefully selected pharmacological therapy are often effective in ameliorating anxiety and depression. Most medical illnesses are influenced by the psychological responses and coping mechanisms that patients use. However, anxiety and depression are associated with dyspnoea, fatigue and altered sleep, all of which also occur in COPD.An understanding of the psychological history and coping mechanisms of patients and the role of anxiety and depressive reactions to illness may enable clinicians to reduce these symptoms and improve quality of life among patients with chronic obstructive pulmonary disease.KEYWORDS: Anxiety, chronic obstructive pulmonary disease, depression C hronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction that is not fully reversible [1]. In addition to the primary pulmonary pathology, the impact of secondary skeletal muscle dysfunction on exercise capacity and survival is well established [2,3]. Psychological impairments, ranging from feelings of depression and anxiety to full diagnostic mental disorders, although prevalent in this population, have received less interest. As COPD is incurable, therapeutic interventions aim to optimise function and slow disease progression [4]. Attention has focused predominantly on the effectiveness of strategies such as smoking cessation [5], longterm oxygen therapy (LTOT) [6,7], influenza vaccines [8], respiratory-specific pharmacological management [9], surgical options [10], conditioning of the peripheral muscles with graduated exercise training [11] and chronic disease selfmanagement strategies [12].Despite the prevalence of depression and anxiety and their impact on the morbidity associated with COPD, these psychological consequences of the disease are rarely addressed, at least in the respiratory medicine community. The purpose of the present review is to raise awareness among pulmonologists, general practitioners and allied health professionals to the secondary psychological impairment associated with COPD. Although anxiety and depression often coexist, they represent separate constructs [13]. Broader reviews of the psychological characteristics of patients with COPD are available [14]. ANXIETY Classification and diagnostic cr...

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Section: Mechanismsmentioning

confidence: 99%

Anxiety and depression in end-stage COPD

Hill

Geist²,

Goldstein³

et al. 2008

Eur Respir J

230

142

View full text Add to dashboard Cite

show abstract

“…cognitive behaviour therapy) have also been used in this same population to manage anxiety, depression, QOL, [5][6][7][8][9][10][11] dyspnoea 12 and exercise tolerance. 13 Over the last decade, four systematic reviews (with and without meta-analysis) have examined the evidence base for psychologically based interventions to alleviate anxiety and depression in people with COPD [14][15][16][17] with one systematic review for adults with asthma. 18 These reviews variously concluded that there was insufficient, 17,18 limited 14,16 and sufficient evidence 15 to support the use of psychological interventions.…”

Section: Introductionmentioning

confidence: 99%

“…13 Over the last decade, four systematic reviews (with and without meta-analysis) have examined the evidence base for psychologically based interventions to alleviate anxiety and depression in people with COPD [14][15][16][17] with one systematic review for adults with asthma. 18 These reviews variously concluded that there was insufficient, 17,18 limited 14,16 and sufficient evidence 15 to support the use of psychological interventions. Each of these reviews included studies where psychological interventions may have been provided in combination with exercise training, and (with the exception of Coventry et al 15 ) did not undertake subgroup analyses to compare different forms of interventions.…”

Section: Introductionmentioning

confidence: 99%

Exercise training combined with psychological interventions for people with chronic obstructive pulmonary disease

2014

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“…It is necessary to initiate and maintain physical activity behaviour change during and after supervised physical exercise training programs. Rose et al, (Baraniak & Sheffield, 2011;Rose et al, 2002) evaluated psychosocial interventions to treat anxiety and panic in patients with COPD; however the data indicated that there were no changes in cognitive function. Overall, the educational intervention may have facilitated aspects of program adherence.…”

Section: Wwwintechopencommentioning

confidence: 99%