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COGNITIVE BEHAVIORAL GROUP THERAPY IMPROVES QUALITY OF LIFE MORE THAN GENERAL HEALTH EDUCATION FOR ANXIETY IN SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE

UTHSCSA and South Texas Veterans Health Care System, San Antonio, TX

PURPOSE: Anxiety and panic attacks frequently occur in patients with Chronic Obstructive Pulmonary Disease (COPD) and negatively impact their quality of life. We undertook this study to determine if Cognitive Behavioral group Therapy (CBT) improves quality of life compared with general education for significant anxiety in patients with severe COPD.

METHODS: We randomly assigned subjects of this pilot study to attend weekly group sessions involving CBT vs. general health education (Educ). Sessions were held for approximately 1.5 hours/week. Measures were evaluated at baseline and 6 weeks following the last group session and included the St. George’s Respiratory Questionnaire (SGRQ) and measures of anxiety and depression (Beck Anxiety Inventory [BAI] and Beck Depression Inventory [BDI]).

RESULTS: A total of 22 subjects (11 per group) completed the study. Demographics were similar between groups, with a mean age of 61.3, Forced Expiratory Volume in one Second (FEV1) of 0.93 FEV1 percent predicted 33.4%, and the number of pack years of cigarettes of 56.5). Only one of the 22 subjects had a diagnosis and/or treatment of anxiety prior to enrollment in this study, despite the entire population having a mean BAI score in the moderate range of anxiety (17.5). The mean change in the SGRQ Symptom, Activity, and Impact scores was –8.14, –4.83, and –5.21, respectively for the CBT group and +5.82, –2.10, and +4.70, respectively for the Educ group. There were no significant differences in the BAI or BDI scores between the two groups.

CONCLUSION: Subjects with severe to very severe COPD and moderate anxiety who attended Cognitive Behavioral group Therapy sessions improved their quality of life scores more than those who attended general health education sessions. In addition, anxiety is often unrecognized and/or suboptimally treated in patients with COPD.

CLINICAL IMPLICATIONS: Recognizing anxiety is important and providing the opportunity for Cognitive Behavioral group Therapy in patients with anxiety and severe COPD may significantly improve their quality of life.

DISCLOSURE: Sandra Adams, None.

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