01.02.18

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A new research project from Aarhus University and Aarhus University Hospital in Denmark shows that eight weeks of mindfulness-based therapy helps patients with chronic obstructive pulmonary disease (COPD) to cope with anxiety and depression.

COPD is an incurable lung disease with severe physical symptoms such as breathlessness, coughing and sputum in the airways. Moreover, many patients with COPD experience psychological problems such as anxiety and depression in everyday life.

Researchers from Aarhus University and Aarhus University Hospital in Denmark have collaborated with researchers from University of Cambridge in England and Trinity College Dublin in Ireland. The researchers have found that an eight-week mindfulness-based cognitive therapy programme relieves patients’ psychological symptoms of anxiety and depression. The results also indicated that mindfulness-based therapy relieved patients’ physical symptoms.

The study has just been published in the acknowledged scientific journal European Respiratory Journal.

Self-compassion strengthens patients

A total of 84 patients with COPD participated in the study. They were randomly assigned either to receive an eight-week mindfulness-based therapy programme in addition to  standard physical rehabilitation or to physical rehabilitation alone. In the mindfulness-based therapy programme, participants practice meditation exercises with the purpose of becoming more aware - in a non-judgmental way – of both positive and negative experiences.

- The results showed that patients who received mindfulness-based therapy in addition to the physical rehabilitation programme experienced significantly fewer symptoms of anxiety and depression after the therapy compared to the patients who had only received physical rehabilitation, says psychologist and PhD student Ingeborg Farver-Vestergaard, who has been in charge of the project.

- In particular, the increased focus on self-compassion, which is a part of the mindfulness-based therapy, relieved symptoms of anxiety and depression.

- It makes good sense because we are dealing with patients who unfortunately often experience self-blame and blame from others because of the role of smoking in the development of COPD. These patients need a large boost of compassion to feel better.

Mindfulness-based therapy may also improve physical symptoms

Mindfulness may also benefit the physical condition of the patients, says Ingeborg Farver-Vestergaard.

- Studies in groups of patients with other diseases such as cancer have found that mindfulness-based therapy can relieve physical symptoms such as pain. We hoped that the psychological therapy could also affect the physical symptoms in patients with COPD such as breathlessness. In our study we saw a tendency that patients randomized to receive the mindfulness-based therapy actually experienced fewer physical symptoms compared with those who received the standard rehabilitation.

 
Good news for an overlooked patient group

Bobby Zachariae, Professor at Unit for Psychooncology and Health Psychology at Aarhus University and Aarhus University Hospital, thinks that mindfulness-based therapy is a good supplement to standard treatment.

- Mindfulness training has the potential to benefit the many patients with COPD who struggle with major challenges in everyday life. It is a patient group which unfortunately is rather overlooked in our society, says Bobby Zachariae.

Anders Løkke, Consultant at Department of Respiratory Diseases and Allergy, Aarhus University Hospital supports this view.

- We have known for a long time that patients with COPD benefit from physical training; it is encouraging that psychological therapy can further improve the well-being of these patients, says Anders Løkke.

Facts:

Chronic Obstructive Pulmonary Disease (COPD)

• Approx. 430,000 Danes have COPD
• COPD develops over time and is usually diagnosed relatively late in life
• The disease is often caused by smoking and/or air pollution and work-related exposures
• The most important and serious symptom is increasing breathlessness
• Other significant symptoms are cough, mucus in airways and fatigue
• 16 Danes die every day because of COPD
• Approx. one third of patients with COPD in rehabilitation experience anxiety and depression
• Anxiety and depression in COPD is often associated with breathlessness, reduced activity level and social isolation.

Behind the research result:

Study design: Cluster randomised controlled trial

Collaborators: Anders Løkke and Elisabeth Bendstrup, Department of Respiratory Diseases and Allergy, Aarhus University Hospital. Kai Ruggeri, University of Cambridge (UK). Frances Early, Addenbrooke’s Hospital (UK), Padraic Dunne and colleagues, Trinity College Dublin (Ireland)

External financing: Danish Lung Association research foundation (Lungeforeningens Forskningsfond), Aase og Ejnar Danielsens Fond; Central Denmark Region Health Research Foundation, A. P. Møller and Chastine Mc-Kinney Møllers Fond til Lægevidenskabens fremme;

Link to the original article: Farver-Vestergaard I, O’Toole MS, O’Connor M, et al. Mindfulness-based cognitive therapy in COPD: a cluster randomised controlled trial. Eur Respir J 2018; 51: 1702082
https://doi.org/10.1183/13993003.02082-2017

Further information:

Ingeborg Farver-Vestergaard, Psychologist and PhD student, Unit for Psychooncology and Health Psychology, Aarhus University and Aarhus University Hospital, e-mail: ifarver@psy.au.dk, Tel.: +45 20 62 10 05

Bobby Zachariae, Professor, DMSci, Unit for Psychooncology and Health Psychology, Aarhus University and Aarhus University Hospital, e-mail: bzach@aarhus.rm.dk, Tel.:+45 87 16 58 78/+45 24 23 53 56

Anders Løkke, Consultant, MD, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, e-mail: andloe@rm.dk, Tel.: +45 28 89 41 97