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Randomized clinical trial on cognitive therapy for depression in women with metastatic breast cancer: Psychological and immunological effects

Published online by Cambridge University Press:  27 September 2006

JOSÉE SAVARD ,
SÉBASTIEN SIMARD ,
ISABELLE GIGUÈRE ,
HANS IVERS ,
CHARLES M. MORIN ,
ELIZABETH MAUNSELL ,
PIERRE GAGNON ,
JEAN ROBERT  and
DANIÈLE MARCEAU
JOSÉE SAVARD
Affiliation:
Laval University Cancer Research Center, Université Laval, Québec, Québec, Canada School of Psychology, Université Laval, Québec, Québec, Canada
SÉBASTIEN SIMARD
Affiliation:
Laval University Cancer Research Center, Université Laval, Québec, Québec, Canada School of Psychology, Université Laval, Québec, Québec, Canada
ISABELLE GIGUÈRE
Affiliation:
Laval University Cancer Research Center, Université Laval, Québec, Québec, Canada
HANS IVERS
Affiliation:
Laval University Cancer Research Center, Université Laval, Québec, Québec, Canada School of Psychology, Université Laval, Québec, Québec, Canada
CHARLES M. MORIN
Affiliation:
School of Psychology, Université Laval, Québec, Québec, Canada
ELIZABETH MAUNSELL
Affiliation:
Population Health Research Unit, Department of Social and Preventive Medicine, Université Laval, Québec, Québec, Canada Centre des maladies du sein Deschênes-Fabia, Hôpital du St-Sacrement, Québec, Québec, Canada
PIERRE GAGNON
Affiliation:
Faculty of Pharmacy, Université Laval, Québec, Québec, Canada Maison Michel-Sarrazin, Québec, Québec, Canada
JEAN ROBERT
Affiliation:
Centre des maladies du sein Deschênes-Fabia, Hôpital du St-Sacrement, Québec, Québec, Canada
DANIÈLE MARCEAU
Affiliation:
L'Hôtel-Dieu de Québec, Québec, Québec, Canada
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Abstract

Objective: Depression is particularly prevalent in patients with advanced cancer. Cognitive therapy (CT) is an empirically supported treatment for depression in the general population. However, efficacy remains to be demonstrated in patients with advanced cancer. A prior controlled trial of CT in a group format showed improvements in depression, mood disturbance, and self-esteem; however, these effects were not maintained over time. Studies examining the efficacy of individual format CT interventions that may ensure more long-term maintenance of benefits are necessary. This study assessed the efficacy of CT for depression administered individually in women with metastatic breast cancer and its effect on immune function.

Method: Forty-five women were randomly assigned to either individual CT or to a waiting-list control (WLC) condition. CT was composed of eight weekly sessions of CT and three booster sessions administered at 3-week intervals following the end of treatment.

Results: Patients treated with CT had significantly lower scores on the Hamilton Depression Rating Scale at posttreatment compared to untreated patients. Pooled data from both groups indicated significant reductions of depressive symptoms from pre- to posttreatment, as well as reduction of associated symptoms including anxiety, fatigue, and insomnia symptoms. These effects were well sustained at the 3- and 6-month follow-up evaluations. CT for depression did not appear to have a significant impact on immune functioning.

Significance of results: Findings of this study support the efficacy of CT for depression in this population and suggest that the administration of individual and booster sessions after treatment termination may be instrumental in sustaining the treatment effects over time.

Keywords

Cognitive therapyMetastatic breast cancerDepressionImmunity
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 3 , September 2006 , pp. 219 - 237
Copyright
© 2006 Cambridge University Press

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