Emotional, intellectual and physiological predictors of vocational outcome of pulmonary rehabilitation patients

Psychological characteristics of patients with chronic obstructive pulmonary disease: a review

OBJECTIVE

The aim of this study was to review research on psychological characteristics in chronic obstructive pulmonary disease (COPD) patients and to summarize the findings of associations between psychological variables and various aspects of life, illness, and health in COPD patients.

METHODS

The following databases were searched: Medline, PsycINFO, and the Cochrane Library.

RESULTS

A total of 81 studies, published between 1968 and 2004, was identified. The reviewed studies indicated that patients suffering from COPD have a high prevalence of psychological disorders and may function at a reduced level of efficiency due to neuropsychological impairments. Psychological characteristics also seemed to be associated with functional disability and reduced quality of life.

CONCLUSION

Psychological characteristics are important variables that interact with physical symptoms, and they should be taken into account when treating COPD patients. More studies with rigorous methodological designs are needed to describe the role of psychological variables in COPD accurately and reliably.

The psychological impact of end-stage lung disease

STUDY OBJECTIVES

End-stage lung disease is associated with poor quality of life and increased risk for psychological distress. Despite the significant number of individuals with end-stage lung diseases, the emotional health of these patients, as compared with those with other chronic organ diseases, is not well-known. The purpose of this article is to elucidate personality styles and the presence of psychopathology in a clinical sample of patients with end-stage lung disease presenting for possible lung transplantation.

DESIGN

Cross-sectional survey.

SETTING

Two academic medical center transplant programs.

PARTICIPANTS

Two hundred forty-three consecutively referred transplant candidates.

RESULTS

Cluster analysis of the Minnesota Multiphasic Personality Inventory (MMPI)-2 indicated five different personality styles. The majority of patients evidenced mild somatic and depressive symptoms. Approximately one fourth of the sample exhibited marked anxiety and mood disturbances. A small cluster also evidenced features consistent with an antisocial personality style.

CONCLUSIONS

Separate and distinct personality styles that could affect quality of life, the need for adjunct treatments, and medical compliance emerged from this sample of individuals with end-stage lung disease. Results are discussed in light of prior research on other end-stage organ conditions and in relation to personality and coping theories.

Psychological treatment of an asthmatic patient in crisis. Dreams, biofeedback, and pain behavior modification

The purpose of this paper is to discuss a unique, integrated combination of various psychological methods that can be used in the treatment of asthma during an acute episode, as well as in long-term management. Illustrated by a case presentation, the therapeutic approach, totaling 14 treatment sessions for the patient and his wife, included: a psychological evaluation, the use of pain behavior-modification procedures usually performed conjointly with the patient's wife, the analytical use of dreams, the desensitization of anxiety present in dream material, and autogenic therapy combined with thermal biofeedback (i.e., using digital temperature to measure relaxation) both at the medical center and at home. Electromyography (EMG)--a measurement of tension--and electrodermal (EDR)--a measurement of galvanic skin response--biofeedback instruments were used nosologically and therapeutically to measure psychophysiological changes, as well as to reduce emotional stresses related to the patient's asthmatic condition.