A review of the effectiveness of psychological interventions used for anxiety and depression in chronic obstructive pulmonary disease
Sheree M S Smith, Sandra Sonego, Leah Ketcheson, Janet L Larson, Sheree M S Smith, Sandra Sonego, Leah Ketcheson, Janet L Larson
Abstract
Background: Anxiety and depression are recognised co-morbidities associated with COPD and have been related to poor health outcomes. Therapies to relieve anxiety and depression are currently not detailed in clinical guidelines.
Methods: A systematic review of psychological interventions for anxiety and depression in adults with COPD was conducted. Meta-analysis utilising the random effects model was undertaken for 4 studies that employed the same psychological intervention type, Cognitive Behavioural Therapy (CBT).
Results: Seven studies met the inclusion criteria. Four studies used CBT. Included studies utilised psychotherapy, uncertainty management and minimal psychological therapy. 70% of participants were male. Many studies had poor methodological quality. The meta-analysis showed a small decrease in symptoms for both anxiety (SMD -0.49, 95% CI -1.04, 0.06, P=0.08, n=193) and depression (SMD -0.37, 95% CI -0.86, 0.11, P=0.13, n=193). No change occurred when sensitivity analyses were conducted.
Conclusion: Anxiety and depression in COPD patients are known to impact on health outcomes. Effective psychological interventions such as CBT may assist people with COPD in reducing psychological burden. There remains a need for well-designed studies to provide substantive evidence for the use of psychological interventions in this patient population.
Figures
References
- World Health Organization. Global burden of disease. Secondary Global burden of disease 01/06/2013 2004.
- Marinho P, Castro C, Raposo C et al. . Depressive symptoms, inflammatory markers and body composition in elderly with and without chronic obstructive pulmonary disease (COPD). Arch Gerentol Geriatr 2012;54:453–8.
- Kuhl K, Schurmann W, Rief W. Mental disorders and quality of life in COPD patients and their spouses. Int J Chron Obstruct Pulmon Dis 2008;3:727–36.
- Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J 2009;33:1165–85.
- Global Initiative for Chronic Obstructive Lung Disease. Management and prevention of chronic obstructive pulmonary disease. Secondary management and prevention of chronic obstructive pulmonary disease 2010.
- Dahlén I, Janson C. Anxiety and depression are related to the outcome of emergency treatment in patients with obstructive pulmonary disease. Chest 2002;122:1633–7.
- Yohannes A, Baldwin R, Connolly M. Mood disorders in elderly patients with chronic obstructive pulmonary disease. Rev Clin Gerentology 2000;10:193–202.
- Burgess A, Kunik M, Stanley M. Chronic obstructive pulmonary disease: assessing and treating psychological issues in patients with COPD. Geriatrics 2005;60:18–21.
- Hynninen M, Pallesen S, Nordhus I. Factors affecting health status in COPD patients with co-morbid anxiety or depression. Int J Chron Obstruct Pulmon Dis 2007;2:323–8.
- Lamers F, Jonkers CC, Bosma H et al. . Improving quality of life in depressed COPD patients: effectiveness of a minimal psychological intervention. COPD 2010;7:315–22.
- Rose C, Wallace L, Dickson R et al. . The most effective psychologically-based treatments to reduce anxiety and panic in patients with chronic obstructive pulmonary disease (COPD): a systematic review. Patient Educ Couns 2002;47:311–18.
- Cafarella PA, Effing TW, Usmani ZA et al. . Treatments for anxiety and depression in patients with chronic obstructive pulmonary disease: a literature review. Respirology 2012;17:627–38.
- Cully J, Graham D, Stanley M et al. . Quality of life in patients with chronic obstructive pulmonary disease and comorbid anxiety or depression. Psychosomatics 2006;47:312–19.
- Jacobs J, Lisdonk Evd, Smeele I et al. . Management of patients with asthma and COPD: monitoring quality of life and the relationship to subsequent GP interventions. Fam Pract 2001;18:574–80.
- Stanley MA, Veazey C, Hopko D et al. . Anxiety and depression in chronic obstructive pulmonary disease: a new intervention and case report. Cogn Behav Pract 2005;12:424–36.
- Kim H, Kunik M, Molinari V et al. . Functional impairment in COPD patients: the impact of anxiety and depression. Psychosomatics 2000;41:465–71.
- Laurin C, Moullec G, Bacon S et al. . The impact of psychological distress on exacerbation rates in COPD. Ther Adv Respir Dis 2011;5:3–18.
- Lacasse Y, Goldstein R, Lasserson T et al. . Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2006;18:1–7.
- Baraniak A, Sheffield D. The efficacy of psychologically based interventions to improve anxiety, depression and quality of life in COPD: a systematic review and meta-analysis. Patient Educ Couns 2011;83:29–36.
- Norweg A, Whiteson J, Malgady R et al. . The effectiveness of different combinations of pulmonary rehabilitation program components: a randomized controlled trial. Chest 2005;128:663–72.
- Putman-Casdorph H, McCrone S. Chronic obstructive pulmonary disease, anxiety, and depression: state of the science. Heart Lung 2009;38:34–47.
- Liberati A, Altman DG, Tetzlaff J et al. . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700.
- American Psychological Association. Presidential task force on evidence-based practice in psychology 2005 policy statement. Secondary Presidential task force on evidence-based practice in psychology 2005 policy statement 2005.
- Pai A, Drotar D, Zebracki K et al. . A meta-analysis of the effects of psychological interventions in pediatric oncology on outcomes of psychological distress and adjustment. J Pediatr Psychol 2006;31:978–88.
- Critical Appraisal Skills Programme. Critical Appraisal Skills Programme: Making sense of evidence. Secondary Critical Appraisal Skills Programme: Making sense of evidence 2013.
- Scottish Intercollegiate Guidelines Network. Critical appraisal: Notes and checklists. Secondary Critical appraisal: Notes and checklists 2014.
- Deeks J, Higgins J, Altman D. Chapter 9: analysing data and undertaking meta-analyses. In: Higgins J, Green S, eds. Cochrane handbook for systematic reviews of interventions. John Wiley & Sons Ltd. 2008:243–93.
- Coventry PA, Bower P, Keyworth C et al. . The effect of complex interventions on depression and anxiety in chronic obstructive pulmonary disease: systematic review and meta-analysis. PLoS ONE 2013;8:e60532.
- Coventry PA, Gellatly JL. Improving outcomes for COPD patients with mild-to-moderate anxiety and depression: a systematic review of cognitive behavioural therapy. Br J Health Psychol 2008;13:381–400.
- Borenstein M, Hedges LV, Higgins JPT. Introduction to meta-analysis. Hoboken, NJ: John Wiley & Sons, 2009.
- Cohen J. Statistical power analysis for the behavioral sciences. 2nd edn: Lawrence Erlbaum Associates, 1988.
- de Godoy DV, de Godoy RF. A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2003;84:1154–7.
- Hynninen M, Bjerke N, Pallesen S et al. . A randomized controlled trial of cognitive behavioral therapy for anxiety and depression in COPD. Respir Med 2010;104:986–94.
- Jiang X, He G. Effects of an uncertainty management intervention on uncertainty, anxiety, depression, and quality of life of chronic obstructive pulmonary disease outpatients. Res Nurs Health 2012;35:409–18.
- Kunik ME, Braun U, Stanley MA et al. . One session cognitive behavioural therapy for elderly patients with chronic obstructive pulmonary disease. Psychol Med 2001;31:717–23.
- Kunik ME, Veazey C, Cully JA et al. . COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychol Med 2008;38:385–96.
- Livermore N, Sharpe L, McKenzie D. Prevention of panic attacks and panic disorder in COPD. Eur Respir J 2010; 35:557–63.
- Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken) 2011;63(Suppl 11):S467–72.
- Spielberger C, Gorsuch R, Lushene R et al. . Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press, 1983.
- Smarr KL, Keefer AL. Measures of Depression and Depressive Symptoms Beck Depression Inventory-II (BDI-II), Center for Epidemiologic Studies Depression Scale (CES-D), Geriatric Depression Scale (GDS), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire-9 (PHQ-9). Arthrtitis Care and Research (Hoboken) 2011;63(Suppl 11):S454–66.
- Beck A, Steer R, Garbin M. Psychometric properties of the Beck Depression Inventory twenty-five years of evaluation. Clin Psychol Rev 1988;8:77–100.
Source: PubMed