title: Does psychodynamic short-term psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial.
abstract: The purpose of this study was to determine (a) the course of fatigue in depressed breast cancer patients, (b) the effect of a depression-focused individual psychodynamic psychotherapy on fatigue, and (c) the associations of fatigue with depression, quality of life and treatment-related variables. In a German multicentre randomized controlled trial in Leipzig and Mainz, depressed early breast cancer patients (UICC stage 0-III, age 18-70 years) were randomly assigned to a short-term psychodynamic psychotherapy (STPP, an adaptation of the Supportive-Expressive psychotherapy by Luborsky for cancer patients) or treatment as usual (TAU) and completed data assessment pre- and post-treatment. Fatigue was assessed with the Multidimensional Fatigue Inventory (MFI-20). All analyses were conducted as complete case analyses including 52 STPP and 54 TAU completers (n = 106). The trial is registered at http://www.controlled-trials.com , number ISRCTN96793588. Fatigue declined significantly from a high level pre-treatment to post-treatment, but remained significantly higher than among population-based controls and a mixed sample of cancer patients. Significant time by group interactions favoured STPP for the subscales reduced activity and physical fatigue and the total scale. The strength of the associations between total fatigue and depression increased from 0.49 pre-treatment to 0.63 (Quality of life -0.52 to -0.63) at follow-up. STPP is beneficial for reducing dimensions of fatigue (particularly reduced activity and physical fatigue) in depressed breast cancer patients. Chronic fatigue needs more clinical attention in this vulnerable group.
authors.affiliation: Department of Mental Health, Medical Psychology & Medical Sociology, Psychosocial Oncology, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany, gregor.weissflog@medizin.uni-leipzig.de.
authors.forename: Gregor
authors.initials: G
authors.lastname: Weißflog
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.forename: Katja
authors.initials: K
authors.lastname: Leuteritz
authors.forename: Yvette
authors.initials: Y
authors.lastname: Barthel
authors.forename: Susanne
authors.initials: S
authors.lastname: Kuhnt
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Zwerenz
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
mesh_terms: D001943:Breast Neoplasms / Q000150:complications* / Q000523:psychology*; D003863:Depression / Q000628:therapy*; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011614:Psychotherapy, Brief; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome