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.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA133050-02
Application #
7937786
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
O'Mara, Ann M
Project Start
2009-09-24
Project End
2014-07-31
Budget Start
2010-08-05
Budget End
2011-07-31
Support Year
2
Fiscal Year
2010
Total Cost
$531,458
Indirect Cost
Name
New York State Psychiatric Institute
Department
Type
DUNS #
167204994
City
New York
State
NY
Country
United States
Zip Code
10032
Okuda, Mayumi; Picazo, Julia; Olfson, Mark et al. (2015) Prevalence and correlates of anger in the community: results from a national survey. CNS Spectr 20:130-9
Goldstein, Benjamin I; Schaffer, Ayal; Wang, Shuai et al. (2015) Excessive and premature new-onset cardiovascular disease among adults with bipolar disorder in the US NESARC cohort. J Clin Psychiatry 76:163-9
Secades-Villa, Roberto; Garcia-Rodríguez, Olaya; Jin, Chelsea J et al. (2015) Probability and predictors of the cannabis gateway effect: a national study. Int J Drug Policy 26:135-42
Okuda, Mayumi; Olfson, Mark; Wang, Shuai et al. (2015) Correlates of intimate partner violence perpetration: results from a National Epidemiologic Survey. J Trauma Stress 28:49-56
Blanco, Carlos; García-Anaya, María; Wall, Melanie et al. (2015) Should pathological gambling and obesity be considered addictive disorders? A factor analytic study in a nationally representative sample. Drug Alcohol Depend 150:129-34
Blanco, Carlos; Iza, Miren; Rodríguez-Fernández, Jorge Mario et al. (2015) Probability and predictors of treatment-seeking for substance use disorders in the U.S. Drug Alcohol Depend 149:136-44
Blanco, Carlos; Hanania, Joan; Petry, Nancy M et al. (2015) Towards a comprehensive developmental model of pathological gambling. Addiction 110:1340-51
Rubio, Jose M; Olfson, Mark; Pérez-Fuentes, Gabriela et al. (2014) Effect of first episode axis I disorders on quality of life. J Nerv Ment Dis 202:271-4
García-Rodríguez, Olaya; Blanco, Carlos; Wall, Melanie M et al. (2014) Toward a comprehensive developmental model of smoking initiation and nicotine dependence. Drug Alcohol Depend 144:160-9
Blanco, Carlos; Rubio, José M; Wall, Melanie et al. (2014) The latent structure and comorbidity patterns of generalized anxiety disorder and major depressive disorder: a national study. Depress Anxiety 31:214-22

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