Behavioral Medicine Approaches to Chronic Obstructive Pulmonary Disease

Abstract

Background Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory disease and associated with considerable individual and socioeconomic burden. Recent research started examining the role of psychosocial factors for course and management of the disease. Purpose This review provides an overview on recent findings on psychosocial factors and behavioral medicine approaches in COPD. Results Research has identified several important psychosocial factors and effective behavioral medicine interventions in COPD. However, there is considerable need for future research in this field. Conclusions Although beneficial effects of some behavioral medicine interventions have been demonstrated in COPD, future research efforts are necessary to study the effects of distinct components of these interventions, to thoroughly examine promising but yet not sufficiently proven interventions, and to develop new creative interventions.

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

“…Although prevalence estimates for these comorbidities vary greatly due to differences in sampling and the use of different instruments [81], a prevalence of 36% for anxiety and 40% for depression appears to be a valid estimate [82]. The incidence of depression in people with COPD is 2.5 times higher compared with the healthy elderly [83].…”

Cognitive behaviour therapy reduces dyspnoea ratings in patients with chronic obstructive pulmonary disease (COPD)

“…Positively attending to and monitoring dyspnoea, and then taking action to manage it, may also increase realistic symptom appraisal and so decrease anxiety about dyspnoea in COPD. Of possible relevance, the results of studies on the use of attentional distraction to reduce perceived exertional dyspnoea in COPD have been mixed, and its use has therefore not been recommended in guidelines (Parshall et al, 2012;von Leupoldt et al, 2012). Carrieri-Kohlman and Murray Gormley (1998) advised against asking COPD patients to distract themselves from acute dyspnoea, after finding that during acute episodes patients reported that they needed to focus on the dyspnoea, with distraction being an ineffective management strategy.…”

Integrative Medicine for Respiratory Conditions

“…75 Mind-body exercise, such as tai chi and yoga, may be helpful to engage deconditioned patients in physical activity either as a bridge, adjunct, and/or alternative to conventional choices. 77,78 …”