title: A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients.
abstract: OBJECTIVE
  Head and neck cancer (HNC) patients have a high incidence of cancer-related posttraumatic stress disorder (PTSD) and other anxiety and depressive disorders. We report the results from the first pilot randomized controlled trial in which the efficacy of an early cognitive-behavioral therapy (CBT) program was compared with a non-directive supportive counseling (SC) intervention in reducing PTSD, general anxiety and depressive symptoms, and improving perceived quality of life in newly diagnosed, distressed HNC patients undergoing radiotherapy.
  
  
  METHODS
  Thirty-five HNC patients (mean age=54.8 years; 80% males) with elevated levels of PTSD, depression or anxiety were randomized to seven individual sessions of a multi-modal CBT or non-directive SC, concurrent with patients' radiotherapy. The SC intervention provided non-directive counseling support. PTSD, anxiety and depressive symptoms (primary outcomes), and cancer-related appraisals and quality of life (secondary outcomes) were assessed pre-intervention (baseline), 1 month, 6 months and 12 months post-intervention by diagnostic clinical interviews and validated self-report questionnaires.
  
  
  RESULTS
  The CBT and SC interventions were found to be equal in their effects in reducing PTSD and anxiety symptoms both in the short and longer term. However, up to 67% of patients in the CBT program no longer met clinical or sub-clinical PTSD, anxiety and/or depression by 12 months post-treatment compared with 25% of patients who received SC.
  
  
  CONCLUSIONS
  Findings indicate that the early provision of psychotherapy has utility in reducing PTSD, anxiety and depressive symptoms, and preventing chronic psychopathology in distressed HNC patients.
authors.affiliation: Centre for Emotional Health, Department of Psychology, Macquarie University, Australia. maria.kangas@mq.edu.au
authors.forename: Maria
authors.initials: M
authors.lastname: Kangas
authors.forename: Chris
authors.initials: C
authors.lastname: Milross
authors.forename: Alan
authors.initials: A
authors.lastname: Taylor
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling / Q000379:methods*; D003863:Depression / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000532:radiotherapy; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life; D057566:Self Report; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult