title: Treatment of depression in patients with breast cancer: a critical review.
abstract: OBJECTIVE
  To summarize current knowledge on psychopharmacological and psychotherapeutic options for patients with breast cancer and comorbid depression, starting from the psychiatric viewpoint. Issues on diagnostic boundaries of depression and outcome measures are raised.
  
  
  METHODS
  We completed a literature review from the last 30 years (until March 2012) using PubMed by pairing the key words: 'breast cancer and depression treatment' (about 1431 works, including 207 reviews), 'breast cancer and antidepressants' (about 305 works, including 66 reviews), and in particular 'selective serotonin reuptake inhibitors and breast cancer' (38 works, including 10 reviews) and 'breast cancer and psychotherapy' (603 works, including 84 reviews). Papers in the English language were selected, including recent reviews.
  
  
  RESULTS
  There is little evidence for the superiority of any one specific intervention with pharmacological options or psychotherapy. The heterogeneity of assessment criteria, the small number of subjects collected in systematic studies, the difficulty in adopting standardized outcome measures, and the limited numbers of available drugs with a favorable side effect profile are the main limitations that emerge from the literature. No conclusive findings are available on mid-term/long-term treatment strategies, or when depression is part of a bipolar disorder.
  
  
  CONCLUSIONS
  Further research is necessary to define the most appropriate approach to depression when it occurs in comorbidity with breast cancer. A more accurate definition of the clinical phenotypes of depression in the special population of patients with breast cancer is suggested as a key issue.
authors.forename: Antonio
authors.initials: A
authors.lastname: Callari
authors.forename: Mauro
authors.initials: M
authors.lastname: Mauri
authors.forename: Mario
authors.initials: M
authors.lastname: Miniati
authors.forename: Maricia
authors.initials: M
authors.lastname: Mancino
authors.forename: Giulia
authors.initials: G
authors.lastname: Bracci
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
authors.forename: Carlo
authors.initials: C
authors.lastname: Greco
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D001943:Breast Neoplasms / Q000523:psychology*; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy / Q000379:methods; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods* / Q000639:trends; D011615:Psychotherapy, Group / Q000379:methods; D012107:Research Design; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000628:therapy; D012944:Social Support; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D017367:Selective Serotonin Reuptake Inhibitors