Interpersonal therapy for depression in Breast Cancer

乳腺癌抑郁症的人际关系治疗

• 批准号: 7737287
• 负责人: CARLOS BLANCO
• 金额: $ 54.12万
• 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/7737287
• 关键词: Adherence; Adult; Affect; Aftercare; Age; Brief Psychotherapy; Build-it; Cancer Patient; Caring; Characteristics; Clinical; Clinical Treatment; Clinical Trials; Comorbidity; Coping Skills; DSM-IV; Data; Depressive disorder; Diagnostic; Diagnostic Neoplasm Staging; Disease; Emotions; Evidence based treatment; Foundations; Individual; Institute of Medicine (U.S.); Literature; Major Depressive Disorder; Malignant Neoplasms; Mediating; Mediator of activation protein; Medical; Medical center; Modeling; Outcome; Outcome Study; Pain; Patients; Pharmaceutical Preparations; Population; Population Heterogeneity; Prevalence; Process; Psychotherapy; Publishing; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recruitment Activity; Research; Severities; Socioeconomic Status; Staging; Supportive care; Symptoms; Therapeutic; Time; Treatment Efficacy; Treatment outcome; United States National Institutes of Health; Work; base; cancer recurrence; cancer therapy; clinical practice; clinically significant; cognitive behavior therapy; comparative efficacy; compliance behavior; control trial; depressed; depression; depressive symptoms; design; effective therapy; experience; flexibility; improved; insight; interpersonal therapy; malignant breast neoplasm; meetings; named group; problem solving therapy; psychosocial; public health relevance; response; satisfaction; social skills; survivorship; symptom management; treatment adherence; treatment response; tumor progression

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: Despite the prevalence and adverse consequences of DSM-IV major depressive disorder (MDD) for breast cancer patients, no established treatments exist. We propose a randomized clinical trial to compare the efficacy of Interpersonal Psychotherapy (IPT), Problem-Solving Therapy (PST) and Brief Supportive Therapy (BSP) in improving depressive symptoms and quality of life among breast cancer patients with MDD. We hope that the results of this study will help to build the urgently needed empirical basis for effective, evidence-based treatments for this population.

描述（由申请人提供）：抑郁症和症状在乳腺癌患者中普遍存在，在癌症治疗过程中恶化，在癌症治疗后持续存在，显着损害生活质量，并降低癌症治疗的依从性和生存率。然而，目前还没有针对乳腺癌患者抑郁症的既定治疗方法。随着幸存的癌症变得越来越普遍，迫切需要建立经验基础，为这一人群提供有效的、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）、问题解决疗法（PST）和短暂支持性心理治疗（BSP）在缓解 DSM-IV 专业乳腺癌患者的抑郁症状和提高生活质量方面的功效抑郁症（MDD）。 IPT 是一种手动、有时限的疗法，在治疗 MDD 方面已显示出反复的疗效，并且在不同年龄范围、文化、形式和治疗方式方面具有显着的灵活性和疗效。 PST 是一种简短的手动认知行为疗法 (CBT)，已用于治疗癌症患者的抑郁症，并显示出非常有希望的结果。 BSP 是临床实践中常用的一种相对非结构化的心理治疗，重点关注患者的情感。它通过仔细、富有同理心地倾听患者的心声、验证并鼓励患者容忍患者的情绪，建立了强大的治疗联盟。它在患有癌症和其他疾病的抑郁症患者中显示出有希望的结果。除了抑郁症状的改善外，还将检查社会人口特征、临床因素、抑郁治疗依从性和结果护理之间的关系。每种情况的患者将在 16 周内接受 12 次治疗，并再随访 4 个月以检查反应的稳定性。我们的模型基于现有文献、我们在乳腺癌患者生存护理方面的长期经验、拟议治疗的理论吸引力和有希望的数据以及广泛的初步数据。此外，拟议的研究将通过检查治疗结果的中介因素和调节因素来深入了解影响关键结果的因素。通过利用富有成效的研究团队提供的有希望的试点数据来研究基于理论的治疗模型，我们相信我们可以帮助为抑郁症乳腺癌患者提供有效治疗提供迫切需要的经验基础。公共卫生相关性：尽管乳腺癌患者 DSM-IV 重度抑郁症 (MDD) 普遍存在并产生不良后果，但尚无既定的治疗方法。我们提出了一项随机临床试验，以比较人际心理治疗 (IPT)、问题解决疗法 (PST) 和短暂支持疗法 (BSP) 在改善患有 MDD 的乳腺癌患者的抑郁症状和生活质量方面的功效。我们希望这项研究的结果将有助于为该人群的有效、循证治疗奠定迫切需要的经验基础。