title: Randomized clinical trial on cognitive therapy for depression in women with metastatic breast cancer: psychological and immunological effects.
abstract: OBJECTIVE
  Depression is particularly prevalent in patients with advanced cancer. Cognitive therapy (CT) is an empirically supported treatment for depression in the general population. However, efficacy remains to be demonstrated in patients with advanced cancer. A prior controlled trial of CT in a group format showed improvements in depression, mood disturbance, and self-esteem; however, these effects were not maintained over time. Studies examining the efficacy of individual format CT interventions that may ensure more long-term maintenance of benefits are necessary. This study assessed the efficacy of CT for depression administered individually in women with metastatic breast cancer and its effect on immune function.
  
  
  METHODS
  Forty-five women were randomly assigned to either individual CT or to a waiting-list control (WLC) condition. CT was composed of eight weekly sessions of CT and three booster sessions administered at 3-week intervals following the end of treatment.
  
  
  RESULTS
  Patients treated with CT had significantly lower scores on the Hamilton Depression Rating Scale at posttreatment compared to untreated patients. Pooled data from both groups indicated significant reductions of depressive symptoms from pre- to posttreatment, as well as reduction of associated symptoms including anxiety, fatigue, and insomnia symptoms. These effects were well sustained at the 3- and 6-month follow-up evaluations. CT for depression did not appear to have a significant impact on immune functioning.
  
  
  CONCLUSIONS
  Findings of this study support the efficacy of CT for depression in this population and suggest that the administration of individual and booster sessions after treatment termination may be instrumental in sustaining the treatment effects over time.
authors.affiliation: Laval University Cancer Research Center, Université Laval, Québec, Québec, Canada. josee.savard@psy.ulaval.ca
authors.forename: Josée
authors.initials: J
authors.lastname: Savard
authors.forename: Sébastien
authors.initials: S
authors.lastname: Simard
authors.forename: Isabelle
authors.initials: I
authors.lastname: Giguère
authors.forename: Hans
authors.initials: H
authors.lastname: Ivers
authors.forename: Charles M
authors.initials: CM
authors.lastname: Morin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Maunsell
authors.forename: Pierre
authors.initials: P
authors.lastname: Gagnon
authors.forename: Jean
authors.initials: J
authors.lastname: Robert
authors.forename: Danièle
authors.initials: D
authors.lastname: Marceau
mesh_terms: D001943:Breast Neoplasms / Q000276:immunology* / Q000473:pathology / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D016207:Cytokines / Q000378:metabolism; D003627:Data Interpretation, Statistical; D003863:Depression / Q000209:etiology / Q000276:immunology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008214:Lymphocytes / Q000276:immunology; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000276:immunology; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D016207:Cytokines