title: Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: a phase II randomized controlled trial.
abstract: BACKGROUND
  Dignity therapy is a brief psychotherapy developed for patients living with a life-limiting illness.
  
  
  OBJECTIVE
  To determine the influence of dignity therapy on depression and anxiety in inpatients with a terminal illness and experiencing a high level of distress in a palliative care unit.
  
  
  METHODS
  A nonblinded phase II randomized controlled trial of 80 patients who were randomly assigned to one of two groups: intervention group (dignity therapy+standard palliative care [SPC]) or control group (SPC alone). The main outcomes were depression and anxiety scores, as measured with the Hospital Anxiety and Depression Scale, and assessed at baseline (T1), day 4 (T2), day 15 (T3), and day 30 (T4) of follow-up. This study is registered with www.controlled-trials.com/ISRCTN34354086.
  
  
  RESULTS
  Of the final 80 participants, 41 were randomly assigned to SPC and 39 to dignity therapy. Baseline characteristics were similar between the two groups. Dignity therapy was associated with a decrease in depression scores (median, 95% confidence interval [CI]: -4.00, -6.00 to -2.00, p<0.0001; -4.00, -7.00 to -1.00, p=0.010; -5.00, -8.00 to -1.00, p=0.043, for T2, T3, and T4, respectively). Dignity therapy was similarly associated with a decrease in anxiety scores (median, 95% CI: -3.00, -5.00 to -1.00, p<0.0001; -4.00, -7.00 to -2.00, p=0.001; -4.00, -7.00 to -1.00, p=0.013, for T2, T3, and T4, respectively).
  
  
  CONCLUSIONS
  Dignity therapy resulted in a beneficial effect on depression and anxiety symptoms in end-of-life care. The therapeutic benefit of dignity therapy was sustained over a 30-day period. Having established its efficacy, future trials of dignity therapy may now begin, comparing it with other psychotherapeutic approaches within the context of terminal illness.
authors.affiliation: 1 Center of Bioethics, Faculty of Medicine of the University of Lisbon , Lisboa, Portugal .
authors.forename: Miguel
authors.initials: M
authors.lastname: Julião
authors.forename: Fátima
authors.initials: F
authors.lastname: Oliveira
authors.forename: Baltazar
authors.initials: B
authors.lastname: Nunes
authors.forename: António
authors.initials: A
authors.lastname: Vaz Carneiro
authors.forename: António
authors.initials: A
authors.lastname: Barbosa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000523:psychology; D010166:Palliative Care / Q000379:methods; D028723:Personhood; D011174:Portugal; D011614:Psychotherapy, Brief / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D013727:Terminal Care / Q000379:methods / Q000523:psychology; D019452:Terminally Ill / Q000523:psychology*