Lungs under a cloud: Psychological aspects of COPD

Psychological aspects are of importance with respect to symptoms in COPD. The research in this thesis focused on several of them.
First, we looked at the association of other medical conditions or depressive symptoms (next to the COPD) with mortality. We found that there was no association.
Also, we investigated partner support and its association with distress (having symptoms of an anxiety or depressive disorder). We found that patients were more distressed when they perceived their partners behaved in a ‘protective buffering’ way (i.e. concealing worries, avoiding negative experiences) or when spouses perceived ‘overprotective behavior’ by partners (i.e. providing unnecessary help) differently from each other.
In addition, we also looked into the relationship between distress and the need for professional psychosocial care. We found that patients with high scores on a distress questionnaire did not necessarily report a need for psychosocial care. Therefore, we question distress questionnaires as a proper way to identify patients with a need for psychosocial care.
We tried to study the effectiveneness of a psychological treatment. However, we were unable to include enough patients in our study. Therefore, we reflect on possible explanations and make recommendations for future psychological treatment studies. We suggest that patient participation in designing studies is important to prevent problems.
Finally, we looked into the worldwide use of translated versions of the Hospital Anxiety and Depression Scale (HADS; a frequently used questionnaire in COPD research). Researchers tend to overlook issues, that could be created (in part) by translation and cross-cultural problems.