It has been suggested that patients with chronic obstructive pulmonary disease (COPD) often experience psychologic depression because of a loss of functional ability. According to this hypothesis, a rehabilitation program that improves function should reduce depression. A total of 119 patients with COPD were randomly assigned to a rehabilitation program or to an education control group. The rehabilitation program was designed to enhance physical functioning and performance of activities of daily living. The education control group received only information without specific instruction or physical activity training. There was a significant improvement in exercise endurance and self-efficacy for the rehabilitation group compared with the education control group after treatment. However, there was not a significant reduction in depression in either group. Patients were then categorized according to increased or decreased depression between the initial assessment and post-treatment evaluation. Within the rehabilitation group, those who had a decrease in depression showed an increase in exercise endurance. Within the education control group, increase or decrease in depression was unrelated to change in exercise endurance. Correlational analyses showed significant associations between baseline measures of depression and functional status. The data are interpreted as partially supporting the functional view of depression in these patients.
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