Depression Screening & Treatment in Ovarian Cancer

描述（由申请人提供）：Eileen Shinn博士获得博士学位。 在临床心理学从俄亥俄州大学，是一个博士后研究员在行为科学系在医学博士。安德森癌症中心。 Shinn博士将利用K 07奖与M。 D. 安德森和四位全国抑郁症和初级保健研究专家（詹姆斯·科因博士、林恩·雷姆博士、约翰·威廉姆斯博士、詹姆斯·布雷博士）。 该项目采用纵向设计，并进行了嵌入式可行性研究，以评估抑郁症的创新干预。 修订后的前瞻性筛查计划已扩大到包括抑郁症的分级筛查策略，以及有关筛查时间、所接受护理质量和可能影响抑郁症的基本心理过程的其他问题。 另一方面，试点干预措施已经缩小规模，现在为患者提供治疗选择，反映了管理式护理环境中抑郁症治疗的现实。 培训计划现在包括正式的课程和研讨会建议的4个共同导师，以及每年的培训旅行博士詹姆斯科因在美国。宾夕法尼亚大学，并定期安排面对面的会议与林恩博士雷姆和詹姆斯布雷，并在较小程度上，约翰威廉姆斯博士。 与辅导小组的正式协议和具体作用已记录在案并予以介绍。 研究和培训计划将在MD进行。安德森，这有一个研究和培训的承诺与众多的教学和合作机会。 医学博士妇科癌症中心。 安德森每年治疗250-300名不同的卵巢癌患者。 重度抑郁症是癌症患者中最常见的精神障碍，严重影响患者的生活质量。 然而，抑郁症在被发现时诊断不足，治疗也不充分。 该研究计划提出要解决许多障碍，阻碍检测和治疗的严重抑郁症在忙碌肿瘤实践设置。 筛查计划现在采用了一种简单的2阶段筛查方法，该方法可能显示出远高于其他筛查工具的阳性预测值。 试点干预将测试抑郁症卵巢癌患者的可行性和可接受性。 它将通过电话和结构化的认知行为治疗（CBT）杂志在患者家中进行。 试点干预将在3个月内持续10次会议，涵盖一系列认知行为技能。 每项技能都将建议从副作用管理和减轻疼痛到对功能丧失的关注等应用程序的选择。 雷姆博士和泰勒博士将共同监督希恩博士在CBT管理。 这种干预是创新的，以前没有对任何癌症患者（包括卵巢癌患者）进行过。

DESCRIPTION (provided by applicant): Dr. Eileen Shinn earned her Ph.D. in Clinical Psychology from Ohio University and is a postdoctoral fellow in the Department of Behavioral Science at M.D. Anderson Cancer Center. Dr. Shinn will use the K07 award to train with a mentoring team comprised of medical and psychosocial experts at M. D. Anderson and four national experts in depression and primary care research (Drs. James Coyne, Lynn Rehm, John Williams, James Bray). This project has a longitudinal design with an embedded feasibility study to evaluate an innovative intervention for depression. The revised prospective screening plan has been expanded to include a hierarchical screening strategy for depression, as well as additional questions about timing of screening, quality of care received, and basic psychological processes which may affect depression. On the other hand, the pilot intervention has been scaled down and now offers patients a choice of treatment, reflecting the reality of depression treatment in managed-care settings. The training plan now includes formal coursework and workshops suggested by the 4 co-mentors, as well as annual training trips to Dr. James Coyne at U. Penn, and regularly scheduled face-to-face meetings with Drs. Lynn Rehm and James Bray, and to a lesser extent, Dr. John Williams. Formal agreements and specific roles with the mentoring team have been documented and are presented. The research and training plan will be conducted at M.D. Anderson, which has a commitment to research and training with numerous didactic and collaborative opportunities. The Gynecologic Cancer Center at M.D. Anderson treats 250-300 different ovarian cancer patients per year. Major depression is the most prevalent psychiatric disorder in cancer patients and severely disables patients' quality of life. Yet depression is underdiagnosed and inadequately treated when recognized. The research plan proposes to address many of the barriers that hinder the detection and treatment of major depression in busy oncology practice settings. The screening plan now features a brief 2-phase screening method which may demonstrate positive predictive value well above other screening instruments. The pilot intervention will test the feasibility and acceptability among depressed ovarian cancer patients. It will be delivered in the patient's home by telephone and a structured cognitive-behavioral therapy (CBT) journal. The pilot intervention will last 10 sessions over 3 months and cover a range of cognitive-behavioral skills. Each skill will suggest a choice of applications ranging from side-effect management and pain reduction, to concerns about losses in functioning. Drs. Rehm and Taylor will co-supervise Dr. Shinn in the CBT administration. This intervention is innovative and has not been done before with any group of cancer patients, including ovarian cancer patients.