An Examination of Cognitive Therapy for Depression in Cancer Patients.
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Depression
- Sponsor
- Ohio State University Comprehensive Cancer Center
- Enrollment
- 25
- Locations
- 1
- Primary Endpoint
- Psychiatric diagnoses, using the Structured Clinical Interview for the DSM-IV (SCID)
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
The purpose of this study is to learn about treatment of depression in people who have any type of cancer. Cognitive therapy (CT) helps improve depressive symptoms by targeting patient's thoughts and behaviors. People who are depressed tend to have more negative or pessimistic thoughts. CT helps people evaluate the accuracy of their thoughts. By encouraging patients to develop more balanced views, symptoms of depression begin to improve
Detailed Description
PRIMARY OBJECTIVES: I. Determine the efficacy of biobehavioral/cognitive therapy for cancer patients/survivors with major depression. II. Test for the covariation between reduction in depressive symptoms and improvements in quality of life. OUTLINE: Patients undergo cognitive behavioral therapy comprising progressive muscle relaxation training, behavioral activation, seeking information as a coping strategy, enhancing social support, cognitive reappraisal, assertive communication, changing depressive core beliefs, goal setting and planning for maintenance, and maintenance over 1 hour once weekly sessions for 12-20 weeks, biweekly sessions for 4-6 weeks, and monthly sessions for 2-3 months for a total of 16-26 sessions. After completion of study treatment, patients are followed up at 3, 6, and 12 months.
Investigators
Barbara Andersen
Principal Investigator
Ohio State University Comprehensive Cancer Center
Eligibility Criteria
Inclusion Criteria
- •Prior diagnosis of invasive cancer, any site, any stage, any time since diagnosis; history of non malignant (basal cell) or low malignant potential (e.g., in situ cervix) cancers do not meet this criterion
- •Diagnosis of major depressive disorder (MDD), according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria (American Psychiatric Association, 2000)
- •Able and willing to give informed consent
Exclusion Criteria
- •History of bipolar affective disorder or psychosis
- •Current axis I disorder (e.g. obsessive-compulsive disorder, specific phobia) other than MDD if it constitutes the predominant aspect of the clinical presentation and if it requires treatment other than that being offered
- •History of substance dependence in the past six months
- •Subnormal intellectual potential (intelligence quotient \[IQ\] below 80)
- •Current suicide risk sufficient to preclude treatment on an outpatient basis
- •Progressive neurological or related conditions/diagnoses
- •Non-ambulatory
- •Life expectancy less than 60 days
Outcomes
Primary Outcomes
Psychiatric diagnoses, using the Structured Clinical Interview for the DSM-IV (SCID)
Time Frame: Up to 12 months
Only modules for mood disorders, anxiety disorders, and substance use disorders will be used. The Global Assessment of Functioning (GAF) Scale will be included as part of the SCID interview. The Longitudinal Interview Follow-Up Evaluation (LIFE) will be used to assess psychosocial, diagnostic, and treatment information. Alpha level will be set at 0.05, beta at 0.20. 95% confidence intervals will be obtained for all outcome measures.
Hamilton Rating Scale for Depression (HRSC) as a measure of depressive symptom severity
Time Frame: Up to 12 months
The modified 17-item HRSD interview codes both responses and behavior. Complete remission of depressive symptoms is indicated by scores of 7 or less, partial remission by scores 8-12, and no remission by scores of 13 or greater. Alpha level will be set at 0.05, beta at 0.20. 95% confidence intervals will be obtained for all outcome measures.
Beck Depression Inventory - 2nd Edition (BDI-II) used to assess the severity of symptoms of depression
Time Frame: Up to 12 months
The BDI-II is a 21-item self-report instrument. Respondents describe their feelings during the past week by rating each item on a scale from 0-3. Thus, possible scores are 0 (minimal depression) to 63 (high depression). Complete remission is indicated by scores of 9 or less, partial remission by scores of 10-16, and no remission by scores of 17 or greater. Alpha level will be set at 0.05, beta at 0.20. 95% confidence intervals will be obtained for all outcome measures.
Secondary Outcomes
- Stress, as measured by the life events scale and the cancer-related Impact of Events Scale (IES)(Up to 12 months)
- Quality of life, as measured by Medical Outcomes Study Short Form, Meaning in Life Scale (MiL), Satisfaction with Life Scale (SWLS), Fatigue Symptom Inventory-Revised (FSI), Brief Pain Questionnaire (BPQ), and Charlson Comorbidity Index (CCI)(Up to 12 months)
- Social relationships, as measured by a single item from the Dyadic Adjustment Scale (DAS), a short form of the Sexual Experience Scale, and the Perceived Social Support From Friends (PSS-Fr) and Family (PSS-Fa)(Up to 12 months)
- Distress, as measured by the Profile of Mood States (POMS), Center for Epidemiological Studies Depression Scale (CES-D) Iowa short form, and the Beck Hopelessness Scale (HS)(Up to 12 months)
- Therapy process & therapy mediators measured by Working Alliance Inventory (WAI), Expectations for Therapy, Attributional Style, COPE, Implicit Self-Relevant Beliefs Assessment (ISRBA), Ways of Responding (WOR), & Evaluation of Topics of the Intervention(Up to 12 months)