Skip to main content

Advertisement

Log in

MBCT for Patients with Respiratory Conditions Who Experience Anxiety and Depression: A Qualitative Study

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

Patients with asthma and chronic obstructive pulmonary disease (COPD) often experience anxiety and depression in relation to their respiratory condition. Anxiety and depression in this population are associated with decreased activity. The aim of this phenomenological study was to carry out in-depth qualitative interviews with a purposive sample of patients with asthma and COPD taking part in an 8-week mindfulness-based cognitive therapy (MBCT) course to explore their experiences of MBCT. In particular, we were interested in how the mindfulness approach helped them, or not, and their awareness of any meaningful changes in relation to their breathlessness, activity levels, anxiety or low mood. Twenty-two patients were recruited from primary and secondary care to receive an 8-week course in MBCT. Two groups of MBCT were taught by qualified MBCT teachers in a community setting. Of the 22 patients who attended the MBCT course, 12 patients were purposively sampled to take part in an in-depth qualitative interview 2 months after completing the MBCT course. Interviews were digitally recorded and transcribed verbatim. Analysis was thematic. The themes that emerged included greater acceptance and reduced sense of disease-related stigma; noticing subtle bodily sensations to detect early warning signs of breathlessness; linking pulmonary rehabilitation advice with mindfulness; developing a new relationship to breathing, activity and associated thoughts; having a greater sense of control; being creative around limitations and removing psychological barriers to being more active. Findings offer, for the first time, qualitative evidence on how MBCT benefits patients with asthma and COPD who experience anxiety and depression. These data provide a useful adjunct to existing quantitative evidence in this area.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Affleck, G., Apter, A., Tennen, H., Reisine, S., Barrows, E., Willard, A., Unger, J., & ZuWallack, R. (2000). Mood states associated with transitory changes in asthma symptoms and peak expiratory flow. Psychosomatic Medicine, 62(1), 61–68.

    Article  PubMed  Google Scholar 

  • Asthma, UK. (2011). Factfile/depression www.asthma.org.uk/all_about_asthma/factfiles/index.html.

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research In Psychology, 3(2), 77–101.

    Article  Google Scholar 

  • Carmody, J., & Baer, R. (2009). How long does a mindfulness-based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of Clinical Psychology, 65, 1–12.

    Article  Google Scholar 

  • Coventry, P., Bower, P., Keyworth, C., Kenning, C., Knopp, J., Garrett, C., Hind, D., Malpass, A., & Dickens, C. (2013). The effect of behavioural interventions on depression and anxiety in COPD: systematic review and meta-analysis. PLoS ONE, 8, e60532.

    Article  PubMed Central  PubMed  Google Scholar 

  • Crane, R. (2009). Mindfulness based cognitive therapy. UK: CBT distinctive series. Routledge.

    Google Scholar 

  • de Godoy, D. V., & de Godoy, R. F. (2003). A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease. Archives of Physical Medicine and Rehabilitation, 84(8), 1154–1157.

    Article  PubMed  Google Scholar 

  • Deshmukh, V., Toelle, B., Usherwood, T., O’Grady, B., & Jenkins, C. (2007). Anxiety, panic and asthma. A cognitive behavioural perspective. Res Medicine, 101(2), 194–202.

    Article  Google Scholar 

  • Egede, L. (2007). Major depression in chronic disorders. General Hospital Psychiatry, 29, 409–416.

    Article  PubMed  Google Scholar 

  • Eisner, M., Blanc, P., Yelin, E., Katz, P., Sanchez, G., & Iribarren, C. (2010). Influence of anxiety on health outcomes in COPD. Thorax, 65(3), 229–234.

    Article  PubMed Central  PubMed  Google Scholar 

  • Epstein, G., Halper, J., Barret, E., Birdsall, C., McGee, M., & Baron, D. (2004). A pilot study of mind-body changes in adults with asthma who practice mental imagery. Alternat Therap Health Med, 14(4), 66–71.

    Google Scholar 

  • Hynninen, M., Bjerke, N., Pallesen, S., Bakke, P., & Nordhus, I. (2010). A randomized controlled trial of cognitive behavioral therapy for anxiety and depression in COPD. Respiratory Medicine, 104(7), 986–994.

    Article  PubMed  Google Scholar 

  • Kabat-Zinn, J. (2011). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Hatchette Books.

  • Kapella, M., Herdegen, J., Perlis, M., Shaver, J., Larson, J., Law, J., & Carley, D. (2011). Cognitive behavioral therapy for insomnia comorbid with COPD is feasible with preliminary evidence of positive sleep and fatigue effects. International Journal of Chronic Obstructive Pulmonary Disease, 6, 625–634.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kessler, R., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K., & Wang, P. (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Jama, 289(23), 3095–3105.

    Article  PubMed  Google Scholar 

  • Kunik, M., Veazey, C., Cully, J., Souchek, J., Graham, D., Hopko, D., et al. (2008). COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychological Medicine, 38(3), 385–396.

    Article  PubMed  Google Scholar 

  • Lamers, F., Jonkers, C., Bosma, H., Diederiks, J., & Eijk, J. (2006). Effectiveness and cost effectiveness of a minimal psychological intervention to reduce non-severe depression in chronically ill elderly patients: the design of a randomized controlled trial. BMC Public Health, 6, 161–170.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lamers, F., Jonkers, C., Bosma, H., Chavannes, N., Knottnerus, J., & van Eijk, J. (2010). Improving quality of life in depressed COPD patients: effectiveness of a minimal psychological intervention. COPD, 7(5), 315–322.

    Article  PubMed  Google Scholar 

  • Livermore, N., Sharpe, L., & McKenzie, D. (2010). Prevention of panic attacks and panic disorder in COPD. European Respiratory Journal, 35(3), 557–563.

    Article  PubMed  Google Scholar 

  • Malpass, A., Carel, H., Ridd, M., Shaw, A., Kessler, D., Sharp, D., Bowden, M., & Wallond, J. (2012). Transforming the perceptual situation: a meta-ethnography of qualitative work exploring patients’ experiences of the therapeutic process of mindfulness based approaches. Mindfulness, 3(1), 60–75.

    Article  Google Scholar 

  • NICE. (2009). Depression with a chronic physical health problem-full guideline. Clinical Guidance 91, 316. Accessed from guidance.nice.org.uk/cg91.

  • Pbert, L., Madison, J. M., Druker, S., Olendzki, N., Magner, R., Reed, G., & Carmody, J. (2012). Effect of mindfulness training on asthma quality of life and lung function: a randomised controlled trial. Thorax, 67(9), 769–776.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rejeski, W. (2008). Mindfulness: reconnecting the body and mind in geriatric medicine and gerontology. The Gerontologist, 48(2), 135–141.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ross, C., Davis, T., & MacDonald, G. (2005). Cognitive behavioral treatment combined with asthma education for adults with asthma and coexisting panic disorder. Clinical Nursing Research, 14(2), 131–157.

    Article  PubMed  Google Scholar 

  • Segal, Z., Williams, M., & Teasdale, J. (2002). Mindfulness based cognitive therapy: a new approach to preventing relapse. UK: Guildford Press.

    Google Scholar 

  • Spruit, M., Watkins, M., Edwards, L., Vestbo, J., Calverley, P., & Pinto-Plata, V. (2010). Determinants of poor 6-min walking distance in patients with COPD: the ECLIPSE cohort. Respiratory Medicine, 104(6), 849–857.

    Article  PubMed  Google Scholar 

  • Tedlock, B. (1991). From participant observation to the observation of participation: the emergence of narrative ethnography. Journal of Anthropological Research, 47(1), 69–94.

    Google Scholar 

  • Wilhelm, K., Mitchell, P., Slade, T., Brownhill, S., & Andrews, G. (2003). Prevalence and correlates of DSM-IV major depression in an Australian national survey. Journal of Affective Disorders, 75(2), 155–162.

    Article  PubMed  Google Scholar 

  • Yellowless, P., & Kalvey, R. (1990). Psychobiological aspects of asthma and consequent research implications. Chest, 97(3), 628–635.

    Article  Google Scholar 

  • Yorke, J., Fleming, S., & Shuldham, C. (2007). Psychological interventions for adults with asthma: a systematic review. Respiratory Medicine, 101(1), 1–14.

    Article  PubMed  Google Scholar 

  • Zigmond, A., & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alice Malpass.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Malpass, A., Kessler, D., Sharp, D. et al. MBCT for Patients with Respiratory Conditions Who Experience Anxiety and Depression: A Qualitative Study. Mindfulness 6, 1181–1191 (2015). https://doi.org/10.1007/s12671-014-0370-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-014-0370-7

Keywords

Navigation