The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review

Abstract

Depression is common in cancer patients, and this often remains undetected and untreated. Depression has been associated with poorer quality of life, in addition to increased impairment of immune response and poorer survival in cancer patients. Previous systematic reviews and meta-analyses of the efficacy of interventions for cancer patients with depression have failed to distinguish between caseness for depression and depressive symptoms. The findings from this systematic review show that there is limited trial data on the efficacy of prescribed antidepressants in reducing the incidence of major depression and depressive symptoms in cancer patients. Contrary to previous reviews that failed to distinguish between depressive symptoms and depression, this review found very little data from clinical trials (without the possibility of confounding factors) to demonstrate that psychotherapeutic interventions are effective in reducing depression in cancer patients. A number of small-scale, single-centre trials indicated that psychotherapeutic interventions (especially cognitive behavioural therapy) can have effects on depressive symptoms in cancer patients. However, given the methodological limitations of studies to date, lack of evidence should not be interpreted as implying lack of efficacy. In conclusion, there is a need for adequately powered studies of pharmacological and psychotherapeutic studies, which are targeted at cancer patients with a diagnosis of depression and include monitoring of the use of other pharmacological/psychotherapeutic and complementary and alternative medicine interventions.

A longitudinal investigation of psychological morbidity in patients with ovarian cancer

“…We have also assessed 'cases' of anxiety and depression rather than symptoms so as to identify clinically significant levels of psychological morbidity rather than just distress, which may be understandable, transitory and less clinically important. Our results support previous findings that anxiety and depression are present after a recent diagnosis of ovarian cancer, and during the treatment of the disease and the follow-up period (Newport and Nemeroff, 1998;Williams and Dale, 2006). We investigated the persistence of psychological disorders by studying the individual variability of anxiety and depression caseness across time.…”

Couples’ discontinuation of fertility treatments: a longitudinal study on demographic, biomedical, and psychosocial risk factors

“…Another study found efficacy of a mind-body study in decreasing depression [63]. Techniques aiming to reduce depression (e.g., cognitive behavioral therapy) have demonstrated efficacy in reducing depression in both infertile patients [64] and other populations (e.g., cancer patients [65]); however, evidence based on discontinuation rates as an outcome is lacking. In addition to clinically depressed women, women with depressive symptomatology should be referred to a mental health professional to prevent not only discontinuation but also other consequences of psychosocial adjustment after ART, including lower self-esteem, low maternal self-efficacy [66], and postpartum depression [67].…”

Depressão e câncer

“…O número de estudos de intervenção, avaliando o uso de antidepressivos em pacientes com câncer, tem aumentado [38][39][40] . As evidências disponíveis sugerem fortemente que a depressão em pacientes com câncer responde aos antidepressivos tricíclicos (TCA), aos inibidores seletivos da recaptura de serotonina (ISRS), à mirtazapina e à mianserina 38 .…”

“…As evidências disponíveis sugerem fortemente que a depressão em pacientes com câncer responde aos antidepressivos tricíclicos (TCA), aos inibidores seletivos da recaptura de serotonina (ISRS), à mirtazapina e à mianserina 38 . Os sintomas cognitivos respondem bem aos antidepressivos serotoninérgicos, enquanto os sintomas neurovegetativos são menos responsivos.…”

“…Dois estudos analisados nessa metanálise foram realizados em pacientes com câncer (mama e ovário). A mianserina apresentou boa eficácia e segurança nas doses de 30 a 60 mg e menor interrupção dos tratamentos 38 .…”