Effect of Individual Cognitive Behavioral Therapy on Depression and Anxiety in Older Adults with Chronic Obstructive Pulmonary Disease : a Feasibility Study

The progression of chronic obstructive pulmonary disease (COPD) in older adults has been associated with a high prevalence of depression and anxiety (Kunik et al., 2005). The purpose of this study was to examine the effects of a COPD-specific individual cognitive behavioral therapy (CBT) intervention on depression and anxiety in older adults with COPD. Three older adult patients with moderate to severe COPD and comorbid depression and anxiety were recruited from a large hospital affiliated pulmonary practice to participate in this single subject multiple baseline feasibility study. Pre-test-post test assessments were conducted utilizing the Geriatric Depression Scale (GDS), the State Trait Anxiety Inventory (STAI), the COPD Self-Efficacy Scale, the St. George Respiratory Questionnaire (SGRQ-C), the Social Problem-Solving Inventory-R (SPSI-R), the MRC Dyspnea Scale, and the Six Minute Walk Distance Test (6MWD). It was hypothesized that this intervention would decrease depression and anxiety; increase self-efficacy and positive problem orientation; increase exercise tolerance; and improve dyspnea management and quality of life for older adults with COPD. The results suggest that depression and anxiety were decreased and self-efficacy increased for all three participants. Dyspnea management and overall quality of life were improved for the two participants who completed the protocol. Changes in exercise tolerance and problem orientation varied by participant. This study has implications for the use of this protocol in a pilot study with a larger sample of older adults with COPD and co-morbid depression and anxiety