Hypnosis versus relaxation for anxiety in COPD pulmonary rehabilitation: a cluster-randomized trial
- 1INSERM, UMRS1158, University Hospital Pitie Salpetriere, Sorbonne University
Abstract
Rationale: Anxiety affects 22-56% of patients with chronic obstructive pulmonary disease and predicts exacerbations, readmissions, and mortality. Mind-body adjuncts to pulmonary rehabilitation are recommended, but trials have lacked comparators isolating technique-specific effects and left determinants of individual benefit unexamined. Objectives: Testing whether adjunctive medical hypnosis reduces anxiety more than matched structured relaxation. Methods: Cluster-randomized, active-comparator trial with patients undergoing pulmonary rehabilitation for chronic obstructive pulmonary disease. Consecutive 4-week inpatient cohorts were randomized 1:1 to adjunctive hypnosis or structured relaxation matched on session length, practitioner pool, and framing. Primary outcome was the six-item State-Trait Anxiety Inventory at week 4 (intention to treat). Complementary multidimensional metrics of anxiety were obtained for robustness. Exploratory analyses tested outcome moderation by baseline sensory-affective dyspnea burden. Measurements and Main Results: Of 80 participants (24 clusters), 79 were analyzed (hypnosis 36, relaxation 43). Hypnosis did not differ from relaxation on the primary outcome (+0.95 points; 95% credible interval -5.85 to 7.42; posterior probability of clinically important hypnosis advantage 0.12) or its complementary metrics. Anxiety improved in both arms (pooled -5.72 points; -9.35 to -2.00). Exploratory analyses showed that the hypnosis advantage rose with baseline sensory and fell with affective burden, reaching -9.26 points at a high-sensory, low-affective profile (-23.37 to 4.71; posterior probability of clinically important hypnosis advantage 0.81). No deaths or serious adverse events occurred. Conclusions: Anxiety improved with no advantage of hypnosis over matched relaxation. Exploratory analysis suggests greater hypnosis benefit in patients with predominantly sensory dyspnea, proposing a candidate phenotype for stratified trials.
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BibTeX
@misc{ghergan2026hypnosis,
title = {{Hypnosis versus relaxation for anxiety in COPD pulmonary rehabilitation: a cluster-randomized trial}},
author = {A. Ghergan and B. Herer and F. Larue and D. Sambourg and I. Segundo and Y. Bocahu and C. Moulin and A. Delignieres and T. Similowski and C. Morelot-Panzini and H. Anllo},
howpublished = {medRxiv},
year = {2026},
month = jul,
doi = {10.64898/2026.07.20.26358482},
url = {https://www.medrxiv.org/content/10.64898/2026.07.20.26358482v2},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Hypnosis versus relaxation for anxiety in COPD pulmonary rehabilitation: a cluster-randomized trial
AU - A. Ghergan
AU - B. Herer
AU - F. Larue
AU - D. Sambourg
AU - I. Segundo
AU - Y. Bocahu
AU - C. Moulin
AU - A. Delignieres
AU - T. Similowski
AU - C. Morelot-Panzini
AU - H. Anllo
PY - 2026
DA - 2026/07/20
PB - medRxiv
DO - 10.64898/2026.07.20.26358482
UR - https://www.medrxiv.org/content/10.64898/2026.07.20.26358482v2
AB - Rationale: Anxiety affects 22-56% of patients with chronic obstructive pulmonary disease and predicts exacerbations, readmissions, and mortality. Mind-body adjuncts to pulmonary rehabilitation are recommended, but trials have lacked comparators isolating technique-specific effects and left determinants of individual benefit unexamined. Objectives: Testing whether adjunctive medical hypnosis reduces anxiety more than matched structured relaxation. Methods: Cluster-randomized, active-comparator trial with patients undergoing pulmonary rehabilitation for chronic obstructive pulmonary disease. Consecutive 4-week inpatient cohorts were randomized 1:1 to adjunctive hypnosis or structured relaxation matched on session length, practitioner pool, and framing. Primary outcome was the six-item State-Trait Anxiety Inventory at week 4 (intention to treat). Complementary multidimensional metrics of anxiety were obtained for robustness. Exploratory analyses tested outcome moderation by baseline sensory-affective dyspnea burden. Measurements and Main Results: Of 80 participants (24 clusters), 79 were analyzed (hypnosis 36, relaxation 43). Hypnosis did not differ from relaxation on the primary outcome (+0.95 points; 95% credible interval -5.85 to 7.42; posterior probability of clinically important hypnosis advantage 0.12) or its complementary metrics. Anxiety improved in both arms (pooled -5.72 points; -9.35 to -2.00). Exploratory analyses showed that the hypnosis advantage rose with baseline sensory and fell with affective burden, reaching -9.26 points at a high-sensory, low-affective profile (-23.37 to 4.71; posterior probability of clinically important hypnosis advantage 0.81). No deaths or serious adverse events occurred. Conclusions: Anxiety improved with no advantage of hypnosis over matched relaxation. Exploratory analysis suggests greater hypnosis benefit in patients with predominantly sensory dyspnea, proposing a candidate phenotype for stratified trials.
ER -