OVERVIEW

• Chronic Obstructive Pulmonary Disease (COPD) is a

progressive disease with persistent respiratory symptoms
needing frequent hospital management.

• The chronicity of the disease and the financial burden leads

to psychiatric illnesses such as depression and anxiety.

• This association leads to a vicious cycle of poor quality of

life and control of the disease.
AIM
• To find out the best non-medical approach for managing
psychological conditions among COPD population.

• Use of non-medical treatment has an effective outcome

according to the current literature.

• However available literature is limited and with poor

quality.

• Thus evaluation of non-pharmacological interventions for

COPD population is important.
METHODOLOGY
• Initial literature search using specialised registers of
two Cochrane Review Groups : Cochrane Review on
anxiety and depression.
• Additional literature search to find interventions on
anxiety and depression among COPD patients using
Medline, PubMed and Ovid etc.
• Finally looked into programs such as electronic apps,
online programs and programs implemented in other
parts of the world such as North America and UK.
RESULTS: INVENTION FROM COCHRANE
META ANALYSIS ON ANXIETY

• Weekly psychotherapy sessions incorporated into

regular pulmonary rehabilitation sessions of
physiotherapy, physical exercise and education.
• Psychotherapy interventions - Cognitive therapy and
logo therapy techniques.
• Outcome: Very strong evidence of improvement of
Anxiety symptoms with incorporating psychotherapy.
RESULTS: INVENTION FROM COCHRANE
META ANALYSIS ON DEPRESSION
Study 1
• Telephone based cognitive behavioural therapy
(CBT) - structured problem-solving, behavioural &
relaxation training and cognitive restructuring.
• Telephone base befriending - discussions on
unbiased, everyday topics and events.
• Outcome: CBT reduced depression symptoms but not
anxiety. Befriending reduced depression symptoms
in the short term and anxiety symptoms in both
short term and long term.
RESULTS: INVENTION FROM
COCHRANE META ANALYSIS ON
DEPRESSION
Study 2
• Mindfulness - based cognitive therapy (MBCT)
intervention added to pulmonary rehabilitation.

• Outcome: When MBCT was added there was clinically

relevant reduction in psychological distress among
COPD patients by reducing symptoms of depression
rather than anxiety.
RESULTS: INVENTION FROM ONLINE
PROGRAMS AND ELECTRONIC APPS
Online Program – “Mindspot”
• Intervention - Free internet delivered psychological assessment
and treatment courses consist of 4 activities to increase
knowledge about symptoms and build practical skills to manage
symptoms.

Electronic Apps - Moodpath: Depression & Anxiety

• Intervention - Assessment of mental health with quizzes, gives
online references to emotional status and resource access to over
150 audio and written exercises based on CBT, guided
meditations and sleep aids.
RESULTS: INVENTION FROM USA AND
NORTH AMERICA CONSUMER GROUPS
USA Consumer Groups - Personalised intervention for
depression and COPD (PID-C)
• Interventions - Providing personalised individual
support and targeted intervention – face to face
discussions and contacting patients’
physicians and informing about status and
adherence.
North America consumer groups - British Lung
Foundation
• Interventions - Telephone directed assessment,
advice on how to manage the condition, providing
CONCLUSIONS
• Comorbidities such as depression and anxiety are common in the
chronicity of COPD
• Interventions focused on more personalized, individualized and non-
pharmacological measures are shown better outcomes.
• Close follow-ups have a significant response to depression and anxiety
outcome for COPD patients.
• Further research should be stimulated among COPD population to build
up a comprehensive intervention for treatment for depression and
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