Objective: Depression is particularly prevalent in patients
with advanced cancer. Cognitive therapy (CT) is an empirically supported
treatment for depression in the general population. However, efficacy
remains to be demonstrated in patients with advanced cancer. A prior
controlled trial of CT in a group format showed improvements in
depression, mood disturbance, and self-esteem; however, these effects were
not maintained over time. Studies examining the efficacy of individual
format CT interventions that may ensure more long-term maintenance of
benefits are necessary. This study assessed the efficacy of CT for
depression administered individually in women with metastatic breast
cancer and its effect on immune function.
Method: Forty-five women were randomly assigned to either
individual CT or to a waiting-list control (WLC) condition. CT was
composed of eight weekly sessions of CT and three booster sessions
administered at 3-week intervals following the end of treatment.
Results: Patients treated with CT had significantly lower scores on
the Hamilton Depression Rating Scale at posttreatment compared to
untreated patients. Pooled data from both groups indicated significant
reductions of depressive symptoms from pre- to posttreatment, as well as
reduction of associated symptoms including anxiety, fatigue, and insomnia
symptoms. These effects were well sustained at the 3- and 6-month
follow-up evaluations. CT for depression did not appear to have a
significant impact on immune functioning.
Significance of results: Findings of this study support the
efficacy of CT for depression in this population and suggest that the
administration of individual and booster sessions after treatment
termination may be instrumental in sustaining the treatment effects over
time.