OBJECTIVE: Head and neck cancer (HNC) patients have a high incidence of cancer-related posttraumatic stress disorder (PTSD) and other anxiety and depressive disorders. We report the results from the first pilot randomized controlled trial in which the efficacy of an early cognitive-behavioral therapy (CBT) program was compared with a non-directive supportive counseling (SC) intervention in reducing PTSD, general anxiety and depressive symptoms, and improving perceived quality of life in newly diagnosed, distressed HNC patients undergoing radiotherapy. PATIENTS AND METHODS: Thirty-five HNC patients (mean age=54.8 years; 80% males) with elevated levels of PTSD, depression or anxiety were randomized to seven individual sessions of a multi-modal CBT or non-directive SC, concurrent with patients' radiotherapy. The SC intervention provided non-directive counseling support. PTSD, anxiety and depressive symptoms (primary outcomes), and cancer-related appraisals and quality of life (secondary outcomes) were assessed pre-intervention (baseline), 1 month, 6 months and 12 months post-intervention by diagnostic clinical interviews and validated self-report questionnaires. RESULTS: The CBT and SC interventions were found to be equal in their effects in reducing PTSD and anxiety symptoms both in the short and longer term. However, up to 67% of patients in the CBT program no longer met clinical or sub-clinical PTSD, anxiety and/or depression by 12 months post-treatment compared with 25% of patients who received SC. CONCLUSION: Findings indicate that the early provision of psychotherapy has utility in reducing PTSD, anxiety and depressive symptoms, and preventing chronic psychopathology in distressed HNC patients.
RCT Entities:
OBJECTIVE: Head and neck cancer (HNC) patients have a high incidence of cancer-related posttraumatic stress disorder (PTSD) and other anxiety and depressive disorders. We report the results from the first pilot randomized controlled trial in which the efficacy of an early cognitive-behavioral therapy (CBT) program was compared with a non-directive supportive counseling (SC) intervention in reducing PTSD, general anxiety and depressive symptoms, and improving perceived quality of life in newly diagnosed, distressed HNC patients undergoing radiotherapy. PATIENTS AND METHODS: Thirty-five HNC patients (mean age=54.8 years; 80% males) with elevated levels of PTSD, depression or anxiety were randomized to seven individual sessions of a multi-modal CBT or non-directive SC, concurrent with patients' radiotherapy. The SC intervention provided non-directive counseling support. PTSD, anxiety and depressive symptoms (primary outcomes), and cancer-related appraisals and quality of life (secondary outcomes) were assessed pre-intervention (baseline), 1 month, 6 months and 12 months post-intervention by diagnostic clinical interviews and validated self-report questionnaires. RESULTS: The CBT and SC interventions were found to be equal in their effects in reducing PTSD and anxiety symptoms both in the short and longer term. However, up to 67% of patients in the CBT program no longer met clinical or sub-clinical PTSD, anxiety and/or depression by 12 months post-treatment compared with 25% of patients who received SC. CONCLUSION: Findings indicate that the early provision of psychotherapy has utility in reducing PTSD, anxiety and depressive symptoms, and preventing chronic psychopathology in distressed HNC patients.
Authors: Jeffrey L Birk; Jennifer A Sumner; Mytra Haerizadeh; Reuben Heyman-Kantor; Louise Falzon; Christopher Gonzalez; Liliya Gershengoren; Peter Shapiro; Donald Edmondson; Ian M Kronish Journal: J Anxiety Disord Date: 2019-03-20
Authors: Karen L Syrjala; Mark P Jensen; M Elena Mendoza; Jean C Yi; Hannah M Fisher; Francis J Keefe Journal: J Clin Oncol Date: 2014-05-05 Impact factor: 44.544
Authors: Donna M Posluszny; Angela Liegey Dougall; Jonas T Johnson; Athanassios Argiris; Robert L Ferris; Andrew Baum; Dana H Bovbjerg; Mary Amanda Dew Journal: Head Neck Date: 2014-09-17 Impact factor: 3.147
Authors: Ingeborg C van der Meulen; Anne M May; Wynand J G Ros; Miriam Oosterom; Gert-Jan Hordijk; Ron Koole; J Rob J de Leeuw Journal: Oncologist Date: 2013-02-21