Cancer, dépression et anxiété

Manzanera, C.; Lafay, N.; Papet, N.; Senon, Jean-Louis

doi:10.1016/s0003-4487(03)00020-9

Cited by 8 publications

(6 citation statements)

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“…46 The MINI 47 provides a brief and reliable method for diagnosing depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases, Tenth Edition (ICD-10) criteria in cancer patients. [47][48][49][50][51][52][53][54][55] It has been validated against the Structured Clinical Interview for DSM, 56 Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised 57 and the Composite International Diagnostic Interview 58 and has been widely used in cancer patients.…”

Section: Screening and Recruitment Of Advanced Cancer Patientsmentioning

confidence: 99%

Manualised cognitive–behavioural therapy in treating depression in advanced cancer: the CanTalk RCT

Serfaty

King

Nazareth

et al. 2019

Health Technol Assess

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Background With a prevalence of up to 16.5%, depression is one of the commonest mental disorders in people with advanced cancer. Depression reduces the quality of life (QoL) of patients and those close to them. The National Institute for Health and Care Excellence (NICE) guidelines recommend treating depression using antidepressants and/or psychological treatments, such as cognitive–behavioural therapy (CBT). Although CBT has been shown to be effective for people with cancer, it is unclear whether or not this is the case for people with advanced cancer and depression. Objectives To assess the clinical effectiveness and cost-effectiveness of treatment as usual (TAU) plus manualised CBT, delivered by high-level Improving Access to Psychological Therapy (IAPT) practitioners, versus TAU for people with advanced cancer and depression, measured at baseline, 6, 12, 18 and 24 weeks. Design Parallel-group, single-blind, randomised trial, stratified by whether or not an antidepressant was prescribed, comparing TAU with CBT plus TAU. Setting Recruitment took place in oncology, hospice and primary care settings. CBT was delivered in IAPT centres or/and over the telephone. Participants Patients (N = 230; n = 115 in each arm) with advanced cancer and depression. Inclusion criteria were a diagnosis of cancer not amenable to cure, a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of depressive disorder using the Mini-International Neuropsychiatric Interview, a sufficient understanding of English and eligibility for treatment in an IAPT centre. Exclusion criteria were an estimated survival of < 4 months, being at high risk of suicide and receiving, or having received in the last 2 months, a psychological intervention recommended by NICE for treating depression. Interventions (1) Up to 12 sessions of manualised individual CBT plus TAU delivered within 16 weeks and (2) TAU. Outcome measures The primary outcome was the Beck Depression Inventory, version 2 (BDI-II) score at 6, 12, 18 and 24 weeks. Secondary outcomes included scores on the Patient Health Questionnaire-9, the Eastern Cooperative Oncology Group Performance Status, satisfaction with care, EuroQol-5 Dimensions and the Client Services Receipt Inventory, at 12 and 24 weeks. Results A total of 80% of treatments (185/230) were analysed: CBT (plus TAU) (n = 93) and TAU (n = 92) for the BDI-II score at all time points using multilevel modelling. CBT was not clinically effective [treatment effect –0.84, 95% confidence interval (CI) –2.76 to 1.08; p = 0.39], nor was there any benefit for other measures. A subgroup analysis of those widowed, divorced or separated showed a significant effect of CBT on the BDI-II (treatment effect –7.21, 95% CI –11.15 to –3.28; p < 0.001). Economic analysis revealed that CBT has higher costs but produces more quality-adjusted life-years (QALYs) than TAU. The mean service costs for participants (not including the costs of the interventions) were similar across the two groups. There were no differences in EQ-5D median scores at baseline, nor was there any advantage of CBT over TAU at 12 weeks or 24 weeks. There was no statistically significant improvement in QALYs at 24 weeks. Limitations Although all participants satisfied a diagnosis of depression, for some, this was of less than moderate severity at baseline, which could have attenuated treatment effects. Only 64% (74/115) took up CBT, comparable to the general uptake through IAPT. Conclusions Cognitive–behavioural therapy (delivered through IAPT) does not achieve any clinical benefit in advanced cancer patients with depression. The benefit of CBT for people widowed, divorced or separated is consistent with other studies. Alternative treatment options for people with advanced cancer warrant evaluation. Screening and referring those widowed, divorced or separated to IAPT for CBT may be beneficial. Whether or not improvements in this subgroup are due to non-specific therapeutic effects needs investigation. Trial registration Current Controlled Trials ISRCTN07622709. Funding This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 19. See the NIHR Journals Library website for further project information.

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Section: Screening and Recruitment Of Advanced Cancer Patientsmentioning

confidence: 99%

Manualised cognitive–behavioural therapy in treating depression in advanced cancer: the CanTalk RCT

Serfaty

King

Nazareth

et al. 2019

Health Technol Assess

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“…Cette amélioration n'était pas présente chez le groupe de femmes traitées pharmacologiquement. Ces résultats sont d'autant plus pertinents pour les femmes atteintes d'un cancer du sein puisque celles-ci peuvent être plus à risque de souffrir d'une dépression majeure [26].…”

Section: La Thérapie De Couple Axée Sur L'émotionunclassified

“…En plus d'avoir un impact négatif sur la santé physique de la femme atteinte, diverses études ont suggéré que le cancer du sein pouvait induire une psychopathologie (anxiété, humeur dépressive, détresse psychologique) et des dysfonctions sexuelles (baisse de désir, diminution de la satisfaction sexuelle) chez la femme [25,26,30] et aussi chez son conjoint [10,23,27,31]. Ces couples seraient également plus à risque de souffrir de problèmes relationnels [27].…”

Section: Introductionunclassified

“…En plus de nuire à la qualité de vie de ces couples [9], la forte prévalence des difficultés conjugales pourrait avoir un effet négatif sur la santé physique des partenaires [24]. Des recherches ont suggéré que les problèmes de couple pouvaient augmenter les risques de mortalité à la suite d'une maladie [6], diminuer l'efficacité du système immunitaire [26] et augmenter le niveau psychobiologique de stress [1]. Ces résultats revêtent un caractère particulier dans les unions où un des partenaires souffre d'une maladie chronique telle que le cancer du sein chez la femme.…”

Section: Introductionunclassified

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La thérapie de couple axée sur l’émotion (EFT) pour traiter les couples dont la femme a le cancer du sein : une étude exploratoire

et al. 2007

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Le but de cette étude était d'évaluer si les couples dont la femme a le cancer du sein réagissent à la thérapie de couple axée sur l'émotion (EFT) de la même façon que les couples en bonne santé, c'est-à-dire avec un niveau croissant d'interactions positives ainsi qu'avec un niveau croissant d'experiencing (capacité à prendre conscience de ses émotions et à les verbaliser). Les enregistrements des séances de thérapie de deux couples dont la femme présente un cancer du sein ont été évalués. Les résultats suggèrent que le processus thérapeutique des couples dont la femme a le cancer du sein est semblable à celui des couples en bonne santé. Les implications cliniques des résultats sont discutées.Mots clés : Thérapie de couple axée sur l'émotion -Cancer du sein -Thérapie de couple Abstract: The purpose of this study was to determine whether couples with female partners who suffer from breast cancer would respond to emotionally focused therapy (EFT) in the same way as couples with healthy partners (i.e. increasing levels of emotional experiencing and affiliative interactions). The therapeutic sessions of two couples, each with a female partner suffering from breast cancer, were evaluated and coded. The results suggest that the therapeutic process experienced by couples with a female partner suffering from breast cancer is similar to that experienced by couples with partners in normal physical health. We discuss the clinical implications of these results.

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“…En effet, certains symptô mes communs (fatigue, perte d'appétit, troubles du sommeil et de la concentration, baisse de la libido) peuvent se confondre avec les manifestations somatiques induites par les perturbations liées au cancer lui-même ou à ses traitements [6]. Cela impose d'avoir recours à une échelle d'évaluation de l'état dépressif excluant les signes physiques.…”

Section: Objectifsunclassified

Troubles sexuels au cours des traitements antidépresseurs lors de leur utilisation dans les cancers gynécologiques

Perdrizet-Chevallier¹

2007

Psycho Oncologie

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Cancer, dépression et anxiété

Cited by 8 publications

References 0 publications

Manualised cognitive–behavioural therapy in treating depression in advanced cancer: the CanTalk RCT

Manualised cognitive–behavioural therapy in treating depression in advanced cancer: the CanTalk RCT

La thérapie de couple axée sur l’émotion (EFT) pour traiter les couples dont la femme a le cancer du sein : une étude exploratoire

Troubles sexuels au cours des traitements antidépresseurs lors de leur utilisation dans les cancers gynécologiques

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