Authors: Hildegarde Paz-Dı ´az, MD Maria Montes de Oca, MD Jose M. Lo ´pez, MD Bartolome R. Celli, MD Affiliations: From the Pulmonary Division, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela (HP-D, MMdO, JML); and Pulmonary Division, Caritas–St. Elizabeth’s Medical Center, Tufts University, Boston, Massachusetts (BRC). Disclosures: This paper was part of a presentation of the second annual forum young investigator award of the American College of Chest Physicians 2005. Correspondence: All correspondence and requests for reprints should be addressed to Hildegarde Paz, MD, 736 Cambridge Street, Boston, MA 02135. 0894-9115/07/8601-0030/0 American Journal of Physical Medicine & Rehabilitation Copyright © 2006 by Lippincott Williams & Wilkins DOI: 10.1097/PHM.0b013e31802b8eca Pulmonary Rehabilitation Improves Depression, Anxiety, Dyspnea and Health Status in Patients with COPD ABSTRACT Paz-Dı ´az H, Montes de Oca M, Lo ´ pez JM, Celli BR: Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD. Am J Phys Med Rehabil 2007;86:30 –36. Objective: To determine the impact of an 8-wk program of compre- hensive pulmonary rehabilitation on depression, anxiety, dyspnea, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). Design: We studied 24 patients with severe COPD randomized either to pulmonary rehabilitation (PR), (n = 10; FEV1 30  9%) or control (C; n = 14; FEV1 34  11%). The PR program included disease education, energy conservation techniques, relaxation, and exercise in- cluding 20-min arm elevation with dumbbells and 20-min leg exercise sessions three times a week for 8 wks. At baseline and after completion of the program, all patients were evaluated using the Beck Depression Inventory, State Trait Anxiety Inventory (STAI), Modified Medical Re- search Council Scale (MRC), and St. George’s Respiratory Question- naire (SGRQ). Results: After PR, there was a significant improvement in the severity of depression (P  0.01), a decrease in symptoms (P  0.05), an increase in daily living activities (P  0.05), and a decrease in the total score of the SGRQ (P  0.01). Dyspnea measured by the MRC scale was significantly better in the PR group (P  0.01). Conclusions: The present study shows that in patients with severe COPD, pulmonary rehabilitation induces important changes on depres- sion and anxiety independent of changes in dyspnea and health-related quality-of-life. Key Words: Pulmonary Rehabilitation, Quality of Life, Dyspnea, Anxiety, Depression 30 Am. J. Phys. Med. Rehabil. ● Vol. 86, No. 1 RESEARCH ARTICLE Pulmonary