Depression Screening & Treatment in Ovarian Cancer

简介（由申请人提供）：Eileen Shinn博士毕业于俄亥俄大学临床心理学博士学位，现为md安德森癌症中心行为科学系博士后。希恩博士将利用K07奖与一个指导团队进行培训，该团队由安德森医学中心的医学和社会心理专家以及四位抑郁症和初级保健研究方面的国家专家组成。詹姆斯·科因、林恩·雷姆、约翰·威廉姆斯、詹姆斯·布雷)。本项目采用纵向设计，嵌入可行性研究，以评估抑郁症的创新干预措施。修订后的前瞻性筛查计划已扩大到包括抑郁症的分层筛查策略，以及关于筛查时间、接受的护理质量和可能影响抑郁症的基本心理过程的附加问题。另一方面，试点干预措施的规模已经缩小，现在为患者提供了治疗选择，反映了管理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4位共同导师建议的研讨会，以及每年到宾夕法尼亚大学的詹姆斯·科因博士那里进行培训，并定期安排与詹姆斯·科因博士面对面的会议。林恩·雷姆和詹姆斯·布雷，还有约翰·威廉姆斯博士。与指导团队的正式协议和具体角色已经被记录并呈现。研究和培训计划将在md安德森进行，该中心致力于研究和培训，并提供大量的教学和合作机会。安德森妇科癌症中心每年治疗250-300名不同的卵巢癌患者。

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.