Reduced Depression in Cancer Patients with Psychological, Pharmacologic Intervention
In this study, the investigators aimed to develop interventions that target cancer patients at increased risk for developing depression. To meet this aim, the investigators examined the efficacy of psychotherapeutic and pharmacologic interventions for depression in cancer patients by meta-analysis of published randomized clinical trials.
The meta-analysis included 10 randomized controlled trials (6 psychotherapeutic, 4 pharmacologic studies). Collectively, these 10 trials enrolled 1,362 participants with mixed cancer types and stages that had been randomly assigned to treatment groups. Interventions were found to be superior to control conditions in reducing depressive symptoms post-intervention (Hedges' g = 0.43, 95% CI = 0.30–0.56, P<.001). “In the 4 psychotherapeutic trials with follow-up assessment, interventions were more effective than control conditions up to 12–18 months after patients were randomly assigned to treatment groups (P<.001),” the investigators reported. “Although each approach was more effective than the control conditions in improving depressive symptoms (P<.001), subgroup analyses showed that cognitive behavioral therapy appeared more effective than problem-solving therapy (P=.01), but not more effective than pharmacologic intervention (P=.07).”
The investigators concluded that, based on the findings in this study, psychological and pharmacologic approaches can be targeted toward reducing elevated depressive symptoms in cancer patients, but that research into ways to maximize effectiveness, accessibility, and integration into clinical care of interventions is needed.