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Treatment of depression in adults with cancer: a systematic review of randomized controlled trials

Published online by Cambridge University Press:  19 June 2013

J. Walker ,
A. Sawhney ,
C. Holm Hansen ,
S. Ahmed ,
P. Martin ,
S. Symeonides ,
G. Murray  and
M. Sharpe
J. Walker*
Affiliation:
Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
A. Sawhney
Affiliation:
Psychological Medicine Research, University of Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
C. Holm Hansen
Affiliation:
Psychological Medicine Research, University of Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
S. Ahmed
Affiliation:
Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
P. Martin
Affiliation:
Psychological Medicine Research, University of Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, UK
S. Symeonides
Affiliation:
University of Edinburgh Cancer UK Research Centre, Western General Hospital, Edinburgh, UK
G. Murray
Affiliation:
University of Edinburgh Centre for Population Health Sciences, Edinburgh, UK
M. Sharpe
Affiliation:
Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK
*
*Address for correspondence: Dr J. Walker, Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. (Email: [email protected])
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Abstract

Background

Depression is a leading cause of disease burden worldwide and is especially problematic in people with chronic diseases, including cancer. Although depression can be effectively treated in the general population using antidepressant medication and psychological treatments, these treatments may have different benefits and harms in cancer patients. Previous reviews have not adequately addressed this topic. We therefore aimed to determine which, if any, treatments are effective for patients with diagnoses of both cancer and depression.

Method

We conducted a systematic review of relevant randomized controlled trials identified through searches of Medline, EMBASE, PsycINFO and The Cochrane Central Register of Controlled Trials (CENTRAL).

Results

Seven relatively small trials met the selection criteria. These provided some evidence that antidepressant medication, given alone or in combination with a psychological treatment, may be effective. We found no good evidence for psychological treatments given alone or for any other forms of treatment.

Conclusions

There is very limited evidence from clinical trials to guide the treatment of cancer patients with a diagnosis of depression, especially for psychological treatments. High quality trials of treatments for depression in patients with cancer are urgently needed.

Keywords

Cancerdepressionsystematic reviewtreatment
Type
Review Article
Information
Psychological Medicine , Volume 44 , Issue 5 , April 2014 , pp. 897 - 907
Copyright
Copyright © Cambridge University Press 2013 

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References

Akechi, T, Okuyama, T, Onishi, J, Morita, T, Furukawa, TA (2008). Psychotherapy for depression among incurable cancer patients. Cochrane Database of Systematic Reviews 2, CD005537.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Barsevick, AM, Sweeney, C, Haney, E, Chung, E (2002). A systematic qualitative analysis of psychoeducational interventions for depression in patients with cancer. Oncology Nursing Forum 29, 73–84.Google Scholar
Brown, LF, Kroenke, K, Theobald, DE, Wu, J, Tu, W (2010). The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain. Psycho-oncology 19, 734–741.Google Scholar
Bui, QU, Ostir, GV, Kuo, YF, Freeman, J, Goodwin, JS (2005). Relationship of depression to patient satisfaction: findings from the barriers to breast cancer study. Breast Cancer Research and Treatment 89, 23–28.CrossRefGoogle ScholarPubMed
Chinese Society of Psychiatry (2012). The Chinese Classification of Mental Disorders (CCMD). Chinese Society of Psychiatry: China.Google Scholar
Colleoni, M, Mandala, M, Peruzzotti, G, Robertson, C, Bredart, A, Goldhirsch, A (2000). Depression and degree of acceptance of adjuvant cytotoxic drugs. Lancet 356, 1326–1327.CrossRefGoogle ScholarPubMed
Costa, D, Mogos, I, Toma, T (1985). Efficacy and safety of mianserin in the treatment of depression of women with cancer. Acta Psychiatrica Scandinavica (Suppl.) 320, 85–92.Google Scholar
Craft, LL, Vaniterson, EH, Helenowski, IB, Rademaker, AW, Courneya, KS (2012). Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiology, Biomarkers and Prevention 21, 3–19.Google Scholar
Ell, K, Xie, B, Quon, B, Quinn, DI, Dwight-Johnson, M, Lee, PJ (2008). Randomised controlled trial of collaborative care management of depression among low-income patients with cancer. Journal of Clinical Oncology 26, 4488–4496.Google Scholar
Fann, J, Fan, M-Y, Unutzer, J (2009 a). Improving primary care for older adults with cancer and depression. Journal of General Internal Medicine 24 (Suppl. 2) 417–424.Google Scholar
Fann, JR, Berry, DL, Wolpin, S, Austin-Seymour, M, Bush, N, Halpenny, B, Lober, WB, McCorkle, R (2009 b). Depression screening using the Patient Health Questionnaire-9 administered on a touch screen computer. Psycho-oncology 18, 14–22.Google Scholar
Fann, JR, Thomas-Rich, AM, Katon, WJ, Cowley, D, Pepping, M, McGregor, BA, Gralow, J (2008). Major depression after breast cancer: a review of epidemiology and treatment. General Hospital Psychiatry 30, 112–126.Google Scholar
Feng, Y, Wang, XY, Li, SD, Zhang, Y, Wang, HM, Li, M, Cao, K, Ye, YF, Zhang, Z (2011). Clinical research of acupuncture on malignant tumor patients for improving depression and sleep quality. Journal of Traditional Chinese Medicine 31, 199–202.Google Scholar
Fisch, MJ, Loehrer, PJ, Kristeller, J, Passik, S, Jung, SH, Shen, J, Arquette, MA, Brames, MJ, Einhorn, LH; Hoosier Oncology Group (2003). Fluoxetine versus placebo in advanced cancer outpatients: a double-blinded trial of the Hoosier Oncology Group. Journal of Clinical Oncology 21, 1937–1943.Google Scholar
Ganzini, LK (2006). Methylphenidate for depressed cancer patients in hospice. Controlled-trials.com (www.mrw.interscience.wiley.com/cochrane/clcentral/articles/952/CN-00595952/frame.html). Accessed 13 December 2012.Google Scholar
Gilbody, S, Sheldon, T, Wessely, S (2006). Should we screen for depression? British Medical Journal 332, 1027–1030.Google Scholar
Gilbody, SM, House, AO, Sheldon, TA (2001). Routinely administered questionnaires for depression and anxiety: systematic review. British Medical Journal 322, 406–409.Google Scholar
Goldzweig, G, Meirovitz, A, Hubert, A, Brenner, B, Walach, N, Perry, S, Hasson-Ohayon, I, Baider, L (2010). Meeting expectations of patients with cancer: relationship between patient satisfaction, depression, and coping. Journal of Clinical Oncology 28, 1560–1565.Google Scholar
Gordon, LG, Beesley, VL, Scuffham, PA (2011). Evidence on the economic value of psychosocial interventions to alleviate anxiety and depression among cancer survivors: a systemsatic review. Asia-Pacific Journal of Clinical Oncology 7, 96–105.CrossRefGoogle ScholarPubMed
Hart, SL, Hoyt, MA, Diefenbach, M, Anderson, DR, Kilbourn, KM, Craft, LL, Steel, JL, Cuijpers, P, Mohr, DC, Berendsen, M, Spring, B, Stanton, AL (2012). Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. Journal of the National Cancer Institute 104, 990–1004.Google Scholar
Hopko, DR, Armento, ME, Robertson, SM, Ryba, MM, Carvalho, JP, Colman, LK, Mullane, C, Gawrysiak, M, Bell, JL, McNulty, JK, Lejuez, CW (2011). Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: randomised trial. Journal of Consulting and Clinical Psychology 79, 834–849.Google Scholar
Jemal, A, Bray, F, Center, M, Ferlay, J, Ward, E, Forman, D (2011). Global cancer statistics. CA: A Cancer Journal for Clinicians 61, 69–90.Google Scholar
Jiang, X-M, Mi, D-H, Wang, H-Q, Zhang, L (2010). Mental intervention for cancer patients with depression: a systematic review of randomised controlled trials. Chinese Journal of Evidence-Based Medicine 10, 352–355.Google Scholar
Kroenke, K, Theobald, D, Wu, J, Loza, JK, Carpenter, JS, Tu, W (2010 a). The association of depression and pain with health-related quality of life, disability, and health care use in cancer patients. Journal of Pain and Symptom Management 40, 327–341.Google Scholar
Kroenke, K, Theobald, D, Wu, J, Norton, K, Morrison, G, Carpenter, J, Tu, W (2010 b). Effect of telecare management on pain and depression in patients with cancer: a randomized trial. Journal of the American Medical Association 304, 163–171.Google Scholar
Kroenke, K, Zhong, X, Theobald, D, Wu, J, Tu, W, Carpenter, JS (2010 c). Somatic symptoms in patients with cancer experiencing pain or depression: prevalence, disability, and health care use. Archives of Internal Medicine 170, 1686–1694.Google Scholar
Ly, KL, Chidgey, J, Addington-Hall, J, Hotopf, M (2002). Depression in palliative care: a systematic review. Part 2. Treatment. Palliative Medicine 16, 279–284.Google Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, D; PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. British Medical Journal 339, 332–336.Google Scholar
Moslinger-Gehmayr, R, Zaninelli, R, Contu, A, Oberhoff, C, Gutschow, K, Schindler, AE, Staab, HJ (2000). A double-blind comparative study of the effectiveness and tolerance of paroxetine and amitriptyline in treatment of breast cancer patients with clinically assessed depression [in German]. Zentralblatt für Gynäkologie 122, 195–202.Google Scholar
Moussavi, S, Chatterji, S, Verdes, E, Tandon, A, Patel, V, Ustun, B (2007). Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 370, 851–858.Google Scholar
Navari, RM, Brenner, MC, Wilson, MN (2008). Treatment of depressive symptoms in patients with early stage breast cancer undergoing adjuvant therapy. Breast Cancer Research and Treatment 112, 197–201.CrossRefGoogle ScholarPubMed
Ng, CG, Boks, MP, Zainal, NZ, de Wit, NJ (2011). The prevalence and pharmacotherapy of depression in cancer patients. Journal of Affective Disorders 131, 1–7.Google Scholar
NICE (2009). Depression: the treatment and management of depression in adults (update). National Institute for Health and Clinical Excellence. Clinical Guideline CG90 (http://guidance.nice.org.uk/CG90).Google Scholar
Nutt, D, Sharpe, M (2008). Uncritical positive regard? Issues in the efficacy and safety of psychotherapy. Journal of Psychopharmacology 22, 3–6.Google Scholar
Osborn, RL, Demoncada, AC, Feuerstein, M (2006). Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. International Journal of Psychiatry in Medicine 36, 13–34.Google Scholar
Pezzella, G, Moslinger-Gehmayr, R, Contu, A (2001). Treatment of depression in patients with breast cancer: a comparison between paroxetine and amitriptyline. Breast Cancer Research and Treatment 70, 1–10.CrossRefGoogle ScholarPubMed
Pinquart, M, Duberstein, PR (2010). Depression and cancer mortality: a meta-analysis. Psychological Medicine 40, 1797–1810.Google Scholar
Rayner, L, Price, A, Evans, A, Valsraj, K, Higginson, IJ, Hotopf, M (2011). Antidepressants for the treatment of depression in palliative care: systematic review and meta-analysis. Palliative Medicine 25, 36–51.Google Scholar
Razavi, D, Allilaire, JF, Smith, M, Salimpour, A, Verra, M, Desclaux, B, Saltel, P, Piollet, I, Gauvain-Piquard, A, Trichard, C, Cordier, B, Fresco, R, Gullibert, E, Sechter, D, Orth, JP, Bouhassira, M, Mesters, P, Blin, P (1996). The effect of fluoxetine on anxiety and depression symptoms in cancer patients. Acta Psychiatrica Scandinavica 94, 205–210.Google Scholar
Rodin, G, Lloyd, N, Katz, M, Green, E, Mackay, JA, Wong, RK (2007). The treatment of depression in cancer patients: a systematic review. Supportive Care in Cancer 15, 123–136.CrossRefGoogle ScholarPubMed
Rooney, A, Grant, R (2010). Pharmacological treatment of depression in patients with a primary brain tumour. Cochrane Database of Systematic Reviews 3, CD006932.Google Scholar
Sharpe, M, Strong, V, Allen, K, Rush, R, Postma, K, Tulloh, A, Maguire, P, House, A, Ramirez, A, Cull, A (2004). Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs. British Journal of Cancer 90, 314–320.CrossRefGoogle ScholarPubMed
Sheard, T, Maguire, P (1999). The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses. British Journal of Cancer 80, 1770–1780.Google Scholar
Siegel, R, Naishadham, D, Jemal, A (2012). Cancer statistics. CA: A Cancer Journal for Clinicians 62, 10–29.Google Scholar
Sloan, J, Frost, M, Berzon, R, Dueck, A, Guyatt, G, Moinpour, C, Sprangers, M, Ferrans, C, Cella, D; Clinical Significance Consensus Meeting Group (2006). The clinical significance of quality of life assessments in oncology: a summary for clinicians. Supportive Care in Cancer 14, 988–998.Google Scholar
Spitzer, R, Endicott, J (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773–782.Google Scholar
Strong, V, Waters, R, Hibberd, C, Murray, G, Wall, L, Walker, J, McHugh, G, Walker, A, Sharpe, M (2008). Management of depression for people with cancer (SMaRT oncology 1): a randomised trial. Lancet 372, 40–48.Google Scholar
Taylor, D, Paton, C, Kapur, S (2011). Depression and anxiety. In The Maudsley Prescribing Guidelines, 10th edn (ed. Taylor, D., Paton, C. and Kapur, S.), pp. 155–250. Informa Healthcare: London, UK.Google Scholar
The Cochrane Collaboration (2011). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 (http://handbook.cochrane.org/).Google Scholar
van Heeringen, K, Zivkov, M (1996). Pharmacological treatment of depression in cancer patients. A placebo-controlled study of mianserin. British Journal of Psychiatry 169, 440–443.Google Scholar
Walker, J, Holm Hansen, C, Martin, P, Sawhney, A, Thekkumpurath, P, Beale, C, Symeonides, S, Wall, L, Murray, G, Sharpe, M (2013). Prevalence of depression in adults with cancer: a systematic review. Annals of Oncology 24, 895–900.Google Scholar
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar
WHO (2004). The Global Burden of Disease 2004 Update. World Health Organization: Geneva.Google Scholar
Williams, S, Dale, J (2006). The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review. British Journal of Cancer 94, 372–390.Google Scholar
Zhang, L, An, G, Xu, Y (2003). Paroxetine in treatment of cancer patients with anxiety and depression. Chinese Mental Health Journal 17, 482–483.Google Scholar
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