Doyle Colleen, Dunt David, Ames David, Fearn Marcia, You Emily Chuanmei, Bhar Sunil
Australian Catholic University, Melbourne, VIC, Australia.
Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia.
Int J Chron Obstruct Pulmon Dis. 2016 Feb 12;11:327-34. doi: 10.2147/COPD.S100859. eCollection 2016.
COPD is an umbrella term to describe chronic lung diseases that cause limitations in lung airflow, including emphysema and chronic bronchitis. The prevalence of depression and anxiety in people with COPD is high, although these comorbidities are often undiagnosed, untreated, or undertreated. There is a need to identify efficacious treatments for depression and anxiety in people with COPD. Cognitive behavior therapy (CBT) for the treatment of anxiety and depression has a strong evidence base. There has been some success delivering this treatment over the telephone in limited studies. The aim of this study is to evaluate the efficacy of both telephone-administered CBT and befriending on outcomes for patients with diagnosed COPD who have at least mild levels of depression and/or anxiety.
The protocol described in this paper is of a pragmatic randomized controlled trial comparing eight sessions of telephone CBT to an active social control, referred to as befriending. Primary outcome measures will include depression and anxiety symptoms, and secondary outcome measures will include quality of life, self-efficacy, and COPD symptom severity. Participants' satisfaction with the intervention and therapeutic alliance will also be assessed. Measures will be taken pre- and postdelivery of the intervention and again at 8 weeks following the intervention.
People with COPD often have limitations to their mobility because of their breathlessness. They are often already attending many medical appointments and could be reluctant to attend for face-to-face psychological treatment. The results of this study should identify the relative efficacy of CBT delivered over the telephone to this population, which, if successful, may be a cost-effective and more palatable alternative to face-to-face treatment of depression or anxiety for this population.
慢性阻塞性肺疾病（COPD）是一个统称，用于描述导致肺气流受限的慢性肺部疾病，包括肺气肿和慢性支气管炎。COPD患者中抑郁和焦虑的患病率很高，尽管这些合并症常常未被诊断、未得到治疗或治疗不足。需要确定针对COPD患者抑郁和焦虑的有效治疗方法。认知行为疗法（CBT）治疗焦虑和抑郁有强有力的证据基础。在有限的研究中，通过电话提供这种治疗取得了一些成功。本研究的目的是评估电话管理的CBT和交友干预对已确诊的至少有轻度抑郁和/或焦虑的COPD患者结局的疗效。
本文所述方案为一项实用随机对照试验，将八次电话CBT与一种积极的社会对照（称为交友干预）进行比较。主要结局指标将包括抑郁和焦虑症状，次要结局指标将包括生活质量、自我效能感和COPD症状严重程度。还将评估参与者对干预和治疗联盟的满意度。将在干预实施前和实施后以及干预后8周再次进行测量。
COPD患者常因呼吸急促而行动受限。他们通常已经要参加很多医疗预约，可能不愿意参加面对面的心理治疗。本研究结果应能确定电话提供的CBT对该人群的相对疗效，如果成功，这可能是一种具有成本效益且更易被该人群接受的替代面对面治疗抑郁或焦虑的方法。
