Does
pulmonary rehabilitation reduce anxiety and depression in chronic obstructive
pulmonary disease
Symptoms of
anxiety and depression are prevalent in at least 20-40% of patients with
moderate-to-severe chronic obstructive pulmonary disease (COPD) and are known
to affect prognosis and worsen quality of life. This review examines whether
pulmonary rehabilitation can effectively improve psychological status in COPD
patients.
Recent
findings: Over the last decade, evidence has accumulated to show that
comprehensive pulmonary rehabilitation, which includes exercise training and
disease education or psychosocial support or both, can effectively improve
anxiety and depression in COPD. The quality of supporting data varies but
indicates a consistent and homogeneous effect in favour
of pulmonary rehabilitation for anxiety and depression when compared with
conventional community care. Pulmonary rehabilitation also appears to improve
anxiety and depression in rehabilitating COPD patients with less favourable psychosocial health, but its efficacy for
treating more severe and enduring anxiety and depression is largely unproven.
Additionally, it is not certain which components of pulmonary rehabilitation
lead to improved anxiety and depression, and further research is needed to
ensure that psychological benefits accrued during rehabilitation are sustained.
Summary:
Anxiety and depression afflict a significant proportion of COPD patients and
lead to worse patient-centred outcomes. Evidence
supports the use of pulmonary rehabilitation to effectively manage
psychological morbidity in COPD.