Carlos Blanco1, John C Markowitz2, David J Hellerstein2, Arthur M Nezu3, Melanie Wall2, Mark Olfson2, Ying Chen2, Jon Levenson2, Maika Onishi4, Cindy Varona2, Mayumi Okuda2, Dawn L Hershman5. 1. Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, 20892, USA. Carlos.blanco2@nih.gov. 2. Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, 10032, USA. 3. Department of Psychology, Drexel University, Philadelphia, PA, 19104, USA. 4. Department of Hematology and Oncology, Palo Alto Medical Foundation, Sunnyvale, CA, 94086, USA. 5. Cancer Center, Columbia University Medical Center, New York, NY, 10032, USA.
Abstract
PURPOSE:Breast cancer (BC) is a risk factor for major depressive disorder (MDD), yet little research has tested the efficacy of different psychotherapies for depressed women with BC. This study, the largest to date, compared outcomes of three evidence-based, 12-week therapies in treating major depressive disorder among women with breast cancer. METHODS: This randomized trial compared interpersonal psychotherapy (IPT), problem solving therapy (PST), and brief supportive psychotherapy (BSP). Conducted at the outpatient clinic of the New York State Psychiatric Institute/Columbia University, the trial offered bilingual treatment by treatment-specific psychotherapists supervised by treatment experts. The primary outcome was change in the Hamilton Depression Rating Scale (HAM-D) at 12 weeks. Secondary outcomes included other validated patient-reported outcomes for depression and quality of life. RESULTS: Of 179 women with breast cancer screening positive for depression at the Columbia Cancer Center, 134 eligible patients signed informed treatment consent. Half of patients were Hispanic and economically disadvantaged. Most women had stage I (35.2%) or II (36.9%) BC; 9% had stage IV. The three brief psychotherapies showed similar improvements on the HAM-D, with large pre-post effect sizes (d ~ 1.0); a priori defined response rates were 35% for IPT, 50% for PST and 31% for BSP, and remission rates 25%, 30% and 27%, respectively. The three treatments also showed similar improvements in the Quality of Life Enjoyment and Satisfaction Questionnaire. Dropout was high, ranging from 37 to 52% across treatments. Predictors of dropout included having < 16 years of education and annual family income < $20,000. CONCLUSIONS: Among patients who completed treatment, all three psychotherapies were associated with similar, meaningful improvements in depression. Physical distance between the oncology and psychiatric treatment sites might have contributed to high dropout. This study suggests various psychotherapy approaches may benefit patients with breast cancer and major depression.
RCT Entities:
PURPOSE:Breast cancer (BC) is a risk factor for major depressive disorder (MDD), yet little research has tested the efficacy of different psychotherapies for depressedwomen with BC. This study, the largest to date, compared outcomes of three evidence-based, 12-week therapies in treating major depressive disorder among women with breast cancer. METHODS: This randomized trial compared interpersonal psychotherapy (IPT), problem solving therapy (PST), and brief supportive psychotherapy (BSP). Conducted at the outpatient clinic of the New York State Psychiatric Institute/Columbia University, the trial offered bilingual treatment by treatment-specific psychotherapists supervised by treatment experts. The primary outcome was change in the Hamilton Depression Rating Scale (HAM-D) at 12 weeks. Secondary outcomes included other validated patient-reported outcomes for depression and quality of life. RESULTS: Of 179 women with breast cancer screening positive for depression at the Columbia Cancer Center, 134 eligible patients signed informed treatment consent. Half of patients were Hispanic and economically disadvantaged. Most women had stage I (35.2%) or II (36.9%) BC; 9% had stage IV. The three brief psychotherapies showed similar improvements on the HAM-D, with large pre-post effect sizes (d ~ 1.0); a priori defined response rates were 35% for IPT, 50% for PST and 31% for BSP, and remission rates 25%, 30% and 27%, respectively. The three treatments also showed similar improvements in the Quality of Life Enjoyment and Satisfaction Questionnaire. Dropout was high, ranging from 37 to 52% across treatments. Predictors of dropout included having < 16 years of education and annual family income < $20,000. CONCLUSIONS: Among patients who completed treatment, all three psychotherapies were associated with similar, meaningful improvements in depression. Physical distance between the oncology and psychiatric treatment sites might have contributed to high dropout. This study suggests various psychotherapy approaches may benefit patients with breast cancer and major depression.
Entities:
Keywords:
Breast cancer; Brief supportive psychotherapy (BSP); Comorbidity; Interpersonal psychotherapy (IPT); Major depressive disorder; Problem solving therapy (PST); Psychotherapy; Randomized controlled trial
Authors: Y Okano; H Okamura; T Watanabe; M Narabayashi; N Katsumata; M Ando; I Adachi; K Kazuma; T Akechi; Y Uchitomi Journal: Breast Cancer Res Treat Date: 2001-06 Impact factor: 4.872
Authors: J M Donnelly; A B Kornblith; S Fleishman; E Zuckerman; G Raptis; C A Hudis; N Hamilton; D Payne; M J Massie; L Norton; J C Holland Journal: Psychooncology Date: 2000 Jan-Feb Impact factor: 3.894
Authors: Ciro Conversano; Mariagrazia Di Giuseppe; Mario Miccoli; Rebecca Ciacchini; Annarita Di Silvestre; Rosa Lo Sterzo; Angelo Gemignani; Graziella Orrù Journal: Clin Neuropsychiatry Date: 2020-08