The Behavioral Treatment of Depressed Cancer Patients

University Of Tennessee Knoxville, Knoxville TN

Investigators

Linked publications & trials

Abstract

[unreadable] DESCRIPTION (provided by applicant): Among cancer patients, major depression is the most common psychiatric disorder, with as many as 50-85% of patients considered clinically depressed, the majority of which present to a primary care environment for treatment (ct. Stevens, et al., 1995). Among primary care patients with depression, treatment satisfaction is moderate to low and response rates are lower than those anticipated based on the Agency for Health Care Policy and Research Guidelines (Wells et al., 1999). Accordingly, the need to focus on quality improvement has been highlighted (Coyne, 2000). The primary objective of the study is to explore the effectiveness and feasibility of a brief behavioral activation treatment for depression (BA TD; Lejuez, Hopko, & Hopko, 2001) for clinically depressed cancer patients within primary care. The BATD protocol may be a viable means to improve quality of care and quality of life for cancer patients in that the treatment addresses primary symptoms often associated with cancer and depression and may reduce practical problems associated with mainstream psychosocial treatments for depression in primary care (Coyne, 2000). This research is important considering the paucity of psychosocial treatment outcome work focused on depressed cancer patients, methodological limitations of studies, lack of effectiveness research in "real-world" (primary care) settings where most patients present with depressive symptoms, and limitations of existing psychosocial treatments in this context. The design involves the collection of pilot data within a small open trial (N = 12). Using a heterogenous sample, the effects of BATD at post-treatment will be evaluated using clinical, functional, satisfaction, and service utilization outcome measures. Clinical outcomes include measurement of target symptoms (depression) and potentially coexistent clinical conditions (i.e., anxiety, substance use). Functional outcomes will assess functional status and quality of life. Satisfaction outcome will assess patient satisfaction with BATD. Longer-term effects of BATD will be assessed on these variables at 3-month follow- up. The project is an important first step toward developing a large-scale, multi-site, randomized hybrid efficacy-effectiveness study that will assess the clinical utility of BA TD in treating depressed cancer patients within primary care, and the efficacy of this treatment compared with alternative (psychosocial and pharmacological) interventions for depression. [unreadable] [unreadable]