Interpersonal therapy for depression in Breast Cancer

乳腺癌抑郁症的人际关系治疗

• 批准号: 8305134
• 负责人: CARLOS BLANCO
• 金额: $ 51.35万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-24 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8305134
• 关键词: Adherence; Adult; Affect; Aftercare; Age; Brief Psychotherapy; Build-it; Cancer Patient; Caring; Characteristics; Clinical; Clinical Treatment; Clinical Trials; Cognitive Therapy; Comorbidity; Coping Skills; DSM-IV; Data; Depressed mood; Depressive disorder; Diagnostic; Diagnostic Neoplasm Staging; Emotions; Evidence based treatment; Foundations; HIV; Individual; Institute of Medicine (U.S.); Literature; Major Depressive Disorder; Malignant Neoplasms; Mediating; Mediator of activation protein; Medical; Medical center; Mental Depression; Modeling; Outcome; Outcome Study; Pain; Patients; Pharmaceutical Preparations; Population; Population Heterogeneity; Prevalence; Process; Psychotherapy; Publishing; Quality of life; Randomized; Randomized Clinical Trials; Recruitment Activity; Research; Severities; Social Functioning; Socioeconomic Status; Staging; Supportive care; Therapeutic; Time; Treatment Efficacy; Treatment outcome; United States National Institutes of Health; Work; adverse outcome; base; cancer recurrence; cancer therapy; clinical practice; clinically significant; comparative efficacy; compliance behavior; control trial; depressive symptoms; design; effective therapy; experience; flexibility; improved; insight; interpersonal therapy; malignant breast neoplasm; meetings; named group; problem solving therapy; psychosocial; randomized trial; response; satisfaction; social skills; survivorship; symptom management; treatment adherence; treatment response; tumor progression

Depressive disorders and symptoms are prevalent in patients with breast cancer, worsen over the course of cancer treatment, persist after cancer therapy, significantly impair quality of life, and decrease adherence to cancer therapy and survival. Yet, there are no established treatments for depression in breast cancer patients. As surviving cancer becomes increasingly common, there is an urgent need to develop an empirical basis to provide effective, evidence-based treatments to this population. We propose a randomized clinical trial to compare the efficacy of Interpersonal Psychotherapy (IPT), Problem-Solving Therapy (PST), and Brief Supportive Psychotherapy (BSP) in alleviating depressive symptoms and improving quality of life for breast cancer patients with DSM-IV major depressive disorder (MDD). IPT, a manualized, time-limited therapy, has shown repeated efficacy in treating MDD, and remarkable flexibility and efficacy across age ranges, cultures, formats, and modes of delivery. PST is a brief, manualized form of cognitive-behavioral therapy (CBT) that has been adapted to treat depression in cancer patients and shown highly promising results. BSP is a relatively unstructured psychotherapy commonly used in clinical practice that focuses on the patient's affect. It builds a strong therapeutic alliance through listening carefully and empathically to the patient, validating and encouraging toleration of the patient's emotions. It has shown promising results in depressed individuals with cancer and other medical illnesses. In addition to improvement in depressive symptoms, relationships between sociodemographic characteristics, clinical factors, depression treatment adherence, and outcomes care will be examined. Patients in each condition will receive 12 therapy sessions within a 16-week period, and will be followed for another 4 months to examine the stability of response. Our model is based on the existing literature, our long-standing experience in survivorship care of breast cancer patients, the theoretical appeal and promising data of the proposed treatments, and a broad range of preliminary data. In addition, the proposed study will yield insight into factors that influence key outcomes by examining mediators and moderators of treatment outcome. By investigating a theoretically-based treatment model with promising pilot data from a productive research team, we believe we can help generate the urgently needed empirical foundations for the provision of effective treatment to depressed breast cancer patients.

乳腺癌患者普遍存在抑郁症和症状，在整个过程中恶化 癌症治疗，癌症治疗后持续存在，显着损害生活质量，并降低对 癌症治疗和生存。然而，在乳腺癌患者中尚无抑郁症治疗。 随着幸存的癌症变得越来越普遍，迫切需要建立经验基础 为该人群提供有效的，基于证据的治疗方法。 我们提出了一项随机临床试验，以比较人际心理治疗（IPT）的功效， 解决问题的疗法（PST）和简短的支持性心理治疗（BSP）减轻抑郁症 DSM-IV重度抑郁症患者的症状和改善的生活质量 （MDD）。 IPT是一种手动，限时的疗法，在治疗MDD方面反复出现疗效 年龄范围，文化，格式和交付方式之间的灵活性和功效。 PST是简短的，手动的 认知行为疗法（CBT）的形式已适应癌症患者的抑郁症和 显示出高度有希望的结果。 BSP是一种相对非结构化的心理治疗，通常用于临床 专注于患者影响的练习。它通过仔细聆听建立​​了强大的治疗联盟 并同情患者，验证和鼓励对患者情绪的耐受。它显示了 有希望的结果导致患有癌症和其他医学疾病的人。除了改进 在抑郁症状，社会人口统计学特征，临床因素，抑郁之间的关系 将检查治疗依从性和结果护理。每种情况的患者将接受12次治疗 在16周内会议，将遵循再进行4个月的时间来检查 回复。 我们的模型基于现有文献，我们在乳房生存护理方面的长期经验 癌症患者，理论吸引力和拟议治疗的有前途的数据以及广泛的 初步数据。此外，拟议的研究将洞悉影响关键结果的因素 检查治疗结果的介体和主持人。通过研究理论上的治疗 具有生产研究团队的有希望的飞行员数据的模型，我们相信我们可以帮助急切地生成 需要经验基础，以提供有效的乳腺癌患者的有效治疗。