Behavioral Activation and Problem-Solving Therapy for Depressed Breast Cancer Patients

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.

Depressed mood predicts pulmonary rehabilitation completion among women, but not men

“…Further, many barriers to PR attendance and completion are logistical (e.g., routine disruption, transportation, lack of support 11 ), thus any psychotherapy intervention targeting PR attendance should target mood and include active, practical problem-solving of logistical barriers. Behavioral Activation and Problem-solving Therapy are two cognitive-behavioral treatment packages that 1) focus on practical problem-solving, 2) have been effective for treating depression in other chronically ill populations, and 3) have been successfully integrated into medical treatment settings 35, 36 . These treatments may be particularly fitting to simultaneously target PR completion and improved mood, and there is also evidence that these treatments can be provided remotely (e.g., 37 , minimizing the need for patients travel to extra sessions.…”

Intervenciones no farmacológicas para reducir síntomas depresivos en mujeres con cáncer de mama

“…Consiste en un conjunto de técnicas basadas en diálogos con expertos en salud mental que utilizan distintos enfoques como: terapia cognitiva, 13 cognitiva conductual 14 (la más frecuente), cognitiva existencial, 15 activación conductual, 16 psicodinámica breve, 17 resolución de problemas 18 e hipnosis. 19 Todos estos enfoques tienen la finalidad de que la paciente se adapte a su nuevo diagnóstico, afronte la enfermedad, tome las mejores decisiones personales y familiares, y, además, reducen su sufrimiento o angustia respecto a la posibilidad de la muerte.…”

Efficacy of problem‐solving therapy for spouses of men with prostate cancer: A randomized controlled trial

“…PST can be delivered individually, in dyads, or in groups, and has been adapted for many populations, including cancer patients. Studies provide general support for the efficacy of PST interventions for quality of life in cancer patients and survivors, [16][17][18][19] and suggest that changes in problem solving (PS) are the essential mechanism underlying the success of the intervention. 19 Spousal PS has been shown to mediate the relationship between patient and spouse distress.…”