No abstract

Major depressive disorder (MDD) is the most common psychiatric disorder in breast cancer patients. The prevalence of suicidal ideation in breast cancer patients is considerable, and relative to the general population, the prevalence of completed suicide is elevated, particularly in cancer patients with MDD. A major component of suicide prevention is effective treatment of MDD. Although some research has explored the utility of psychotherapy with breast cancer patients, only three trials have explored the benefits of behavior therapy in patients with well-diagnosed MDD and there has been no systematic investigation of the potential benefits of psychotherapy toward reducing suicidal ideation in breast cancer patients. As a follow-up to a recently completed randomized trial, this study examined the efficacy of 8 weeks of behavioral activation treatment for depression (BATD) and problem-solving therapy (PST) in reducing depression and suicidal ideation, as well as increasing hopefulness in breast cancer patients with MDD (n = 80). Across both treatments, GEE analyses revealed decreased depression and suicidal ideation and increased hopefulness at posttreatment, results that were maintained at 12-month follow-up. Moreover, follow-up patient contact at approximately 2 years posttreatment yielded no indication of completed suicide. Although these data are preliminary, BATD and PST may represent practical approaches to decrease suicidal ideation in depressed breast cancer patients.

Coexistent social anxiety disorder (SAD) and major depression can be highly debilitating and cause significant interference with social, occupational, and educational functioning. Cognitive-behavioral therapy (CBT) has been shown to be an effective treatment for SAD and allows for flexibility in treating individuals of diverse cultural backgrounds. At present, treatment outcome research on the efficacy of CBT among Arab individuals with anxiety and mood disorders is highly limited. The current case study presents the implementation of a manualized CBT protocol for an Arab male with SAD and a secondary diagnosis of major depression. With attention to unique cultural influences on the development and maintenance of his symptom presentation, treatment consisted of 14 individual sessions, with outcome data yielding significant reductions in social anxiety, somatic anxiety, and depression at the posttreatment assessment. This case study demonstrates the potential efficacy of manualized CBT for SAD among Arab individuals and highlights the need for further systematic investigation using randomized controlled trials.

The efficacy of behavior therapy for depressed breast cancer patients may depend on several patient variables. Implications for the provision of behavior therapy for breast cancer patients are discussed.

Mindfulness-based therapy (MBT) has shown promise in reducing depression and psychological distress among individuals presenting with various medical and psychiatric problems. This case study examined the implementation of MBT with an undergraduate student with recurrent major depression and generalized anxiety disorder. A novel four-session MBT protocol was utilized and the patient demonstrated significant decreases in depressive and anxiety symptoms and an overall increase in quality of life at the posttreatment assessment. Treatment gains were maintained at the 1-month follow-up assessment. Consistent with previous treatment outcome studies examining the efficacy of comprehensive MBT interventions, results indicate that an abbreviated MBT protocol may be effective in treating depression and anxiety in younger adults.