Interpersonal therapy for depression in Breast Cancer

抑郁障碍和症状在乳腺癌患者中普遍存在，随着病程的发展而恶化。 癌症治疗后持续存在，显著损害生活质量，并降低对 癌症治疗和生存。然而，对于乳腺癌患者的抑郁症还没有确定的治疗方法。 随着癌症幸存者越来越普遍，迫切需要建立一个经验基础， 为这一人群提供有效的循证治疗。 我们提出了一个随机临床试验，比较人际心理治疗（IPT）的疗效， 问题解决疗法（PST）和短期支持性心理疗法（BSP）在缓解抑郁症中的应用 DSM-IV版乳腺癌抑郁障碍患者的症状和生活质量改善 （MDD）。 IPT是一种手动的、有时间限制的治疗方法，在治疗MDD方面已显示出重复的疗效， 灵活性和有效性跨越年龄范围，文化，格式和交付模式。PST是一个简短的， 一种认知行为疗法（CBT），已被用于治疗癌症患者的抑郁症， 显示了非常有希望的结果。BSP是临床上常用的一种相对非结构化的心理治疗方法 专注于患者情感的实践。它通过仔细倾听建立了一个强大的治疗联盟 并对病人产生同情，确认和鼓励病人的情绪的容忍。来所奉行 在患有癌症和其他医学疾病的抑郁症患者中取得了可喜的成果。除了改善 社会人口学特征、临床因素、抑郁症之间的关系 治疗依从性和结果护理将被检查。每种情况的患者将接受12种治疗 在16周的时间内进行，并将再进行4个月的随访，以检查 反应 我们的模型是基于现有的文献，我们在乳腺癌生存护理的长期经验， 癌症患者，所提出的治疗方法的理论吸引力和有希望的数据，以及广泛的 初步数据。此外，拟议的研究将深入了解影响关键结果的因素， 检查治疗结果的中介者和调节者。通过研究一种基于理论的治疗方法 通过一个富有成效的研究团队提供的有希望的试点数据，我们相信我们可以帮助紧急生成 为抑郁的乳腺癌患者提供有效的治疗需要经验基础。

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.