Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: study protocol for a randomized controlled trial

Rüdiger Zwerenz,Susanne Kuhnt,Katja Leuteritz,Gerald Hoffmann,Rolf-Dieter Kortmann,Jörg Wiltink,Uwe Köhler,Marcus Schmidt,Manfred E Beutel,Heinz Schmidberger,Elmar Brähler,Antje Haselbacher,Gregor Weißflog,Yvette Barthel,Christian Ruckes,Dagmar Langanke,Barbara H Imruck

doi:10.1186/1471-2407-12-578

Abstract

BackgroundThere is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. Our study determines the efficacy of a manualized short-term psychodynamic psychotherapy and predictors of outcome by personality and quality of the therapeutic relationship.Methods/designEligible breast cancer patients with comorbid depression are assigned to short-term psychodynamic psychotherapy (up to 20 + 5 sessions) or to treatment as usual (augmented by recommendation for counseling center and physician information). We plan to recruit a total of 180 patients (90 per arm) in two centers. Assessments are conducted pretreatment, after 6 (treatment termination) and 12 months (follow-up). The primary outcome measures are reduction of the depression score in the Hospital Anxiety and Depression Scale and remission of depression as assessed by means of the Structured Clinical Interview for DSM IV Disorders by independent, blinded assessors at treatment termination. Secondary outcomes refer to quality of life.DiscussionWe investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment.Trial registrationISRCTN96793588

Highlights

There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients
We investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment
The main purpose of the ongoing trial is to determine the efficacy of the manualized short-term psychodynamic psychotherapy (STPP) regarding remission of depression in breast cancer patients

Summary

Introduction

There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. There has been positive - somewhat limited evidence for the effectiveness of pharmacological and psychotherapeutic treatments with randomized controlled trials (RCT’s) for depressed cancer patients, e.g. of cognitive behavior and problem-solving therapy for recently diagnosed, mildly to moderately depressed patients and of supportive-expressive group therapy for patients with advanced disease. Studies often suffer from methodological problems, such as selected or small samples, unclear or missing randomization, no manualization or control on treatment adherence. Only a minority of the trials has adequately assessed depression. A recent study ascertained clear preferences of cancer patients regarding speaking about their concerns and fears rather than accepting psychopharmacological treatment [7]

Objectives

Methods

Findings

Conclusion