Depression among cancer patients: A randomised controlled trial comparing standard care with short psychodynamic psychotherapy

About 40% of the cancer patients suffer from depressive disorders which are seldom identified and even more rarely treated. Depression leads to a reduction in quality of life, diminished medical treatment compliance, prolonged hospital stays, and a reduction of global functioning.

Aim of the study: The aim of the study is to compare the effectiveness of a standard treatment based on the guidelines for the management of major depression in the medically ill [1] with a short psychodynamic psychotherapy in cancer patients with major depression (MD) and adjustment disorders (AD) with depressive symptoms in an oncology population [2].

Methods: Cancer patients fulfilling the DSM-IV criteria for a MD and AD are randomly assigned to two groups. The first group receives standard treatment (pharmacotherapy, regular consultations by an oncologist) and the second a short psychodynamic psychotherapy of 16 sessions. Evaluation of effectiveness consists of pre and post intervention results, as well as intermediary and follow-up outcomes.

Results: A total of 30 patients were included in the study, to date. Preliminary results indicate an improvement of depressive symptoms after 8 and 16 weeks in both groups, with a difference, though not statistically significant, favouring the psychotherapy; limitations of the study have to be addressed.

Literatur: 1. Voellinger, R., et al., Major depressive disorder in the general hospital: adaptation of clinical practice guidelines. Gen Hosp Psychiatry, 2003. 25(3): p. 185-93. 2. Stiefel. F., Stagno, D. Intervention psychothérapeutique auprès des patients cancéreux souffrant d'une symptomatologie dépressive ; une étude clinique randomisée. Fondation Kisane 2005-2006.