D1.7 Clinical psychologist/psychiatrist

Anxiety and depression are common disorders in patients with COPD, which worsen quality of life and add to disability (Weiss 2022, O’Toole 2022) [evidence level III]. There is promising evidence that anxiety and depression can be treated by clinical psychologists and psychiatrists using approaches such as cognitive behaviour therapy (Hynninen 2010, Yohannes 2017) [evidence level II]. Psychiatrists can also advise whether pharmacological treatment may be appropriate.

A systematic review of various psychological interventions in patients with COPD showed some improvements in psychological outcomes, especially with cognitive behavioural therapy (CBT). In contrast, for physical outcomes, only mind-body interventions (e.g. mindfulness-based therapy, yoga, and relaxation) revealed a statistically significant effect. These findings favour psychosocial intervention as a tool in the management of COPD (Farver-Vestergaard 2015). A directed psychological intervention consisting of six sessions of group-based CBT delivered by a psychologist added to an eight week pulmonary rehabilitation program, showed significant improvements in the CBT group in the 6-minute walk test (6MWT), fatigue, depression and stress measures (Luk 2017). Telephone-administered CBT can reduce depression symptoms in people with COPD (Doyle 2017).