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Giuseppe Catalfo,1 Luciana Crea,1 Tiziana Lo Castro,1 Francesca Magnano San Lio,1 Giuseppe Minutolo,1 Gherardo Siscaro,2 Noemi Vaccino,1 Nunzio Crimi,3 Eugenio Aguglia1 1Department of Psychiatry, Policlinico “G. Rodolico” University Hospital, University of Catania, Catania, Italy; 2Operative Unit Neurorehabilitation, IRCCS Fondazione Salvatore Maugeri, Sciacca, Italy; 3Department of Pneumology, Policlinico “G. Rodolico” University Hospital, University of Catania, Catania, Italy Background: Several clinical studies suggest common underlying pathogenetic mechanisms of COPD and depressive/anxiety disorders. We aim to evaluate psychopathological and physical effects of aerobic exercise, proposed in the context of pulmonary rehabilitation, in a sample of COPD patients, through the correlation of some psychopathological variables and physical/pneumological parameters. Methods: Fifty-two consecutive subjects were enrolled. At baseline, the sample was divided into two subgroups consisting of 38 depression-positive and 14 depression-negative subjects according to the Hamilton Depression Rating Scale (HAM-D). After the rehabilitation treatment, we compared psychometric and physical examinations between the two groups. Results: The differences after the rehabilitation program in all assessed parameters demonstrated a significant improvement in psychiatric and pneumological conditions. The reduction of BMI was significantly correlated with fat mass but only in the depression-positive patients. Conclusion: Our results suggest that pulmonary rehabilitation improves depressive and anxiety symptoms in COPD. This improvement is significantly related to the reduction of fat mass and BMI only in depressed COPD patients, in whom these parameters were related at baseline. These findings suggest that depressed COPD patients could benefit from a rehabilitation program in the context of a multidisciplinary approach. Keywords: COPD, depression, aerobic exercise, BMI