Depression Treatment: Problem-Focussed Interactive Telephone Therapy for Cancer Patients: A Phase II Feasibility Trial.

Problem-focussed interactive telephone therapy for cancer patients: a phase II feasibility trial.

Filed under: Depression Treatment

Psychooncology. 2012 Oct 18;
Watson M, White C, Davolls S, Mohammed A, Lynch A, Mohammed K

OBJECTIVE: The study aimed to evaluate Problem-Focussed Interactive Telephone Therapy, an individual psychological therapy based on cognitive-behavioural therapy adapted for telephone delivery to cancer patients with high psychological needs. METHODS: A non-randomised, within-group prospective design was used. Outcome measures pre-therapy and post-therapy included were as follows: Hospital Anxiety and Depression Scale, Mental Adjustment to Cancer Scale: helpless/hopeless sub-scale only, Checklist of Cancer Concerns, Cancer Coping Questionnaire and EQ-5D quality of life. A study-specific Service Evaluation Questionnaire was included. Eligible patients were either (i) offered out-patient screening for anxiety/depression/helplessness (n?=?649) or (ii) referred for psychological care by oncology clinicians (n?=?160). RESULTS: Thirty two percent (36/114) of screen-identified cases and 22% (35/160) of referred patients participated, and 42 were available for analysis. There were significant post-therapy improvements in Hospital Anxiety and Depression Scale anxiety (p?=?0.002) and depression (p?=?0.003), Mental Adjustment to Cancer Scale helpless/hopeless (p?=?0.036), cancer concerns (p?=?0.005) and overall quality of life (p?=?0.048). Overall, 81% (34/42) of participants were defined as clinical cases at baseline and 32% were no longer cases post-therapy. There were significant improvements in coping consistent with the therapy method. CONCLUSIONS: A minority of symptomatic patients opt for telephone psychological therapy; however, where they do, there are significant improvements indicating that telephone-delivered therapy is feasible in patients with high needs. Findings are discussed in relation to current issues on the implementation of distress screening and psychological therapy provision within clinical settings.Copyright © 2012 John Wiley & Sons, Ltd.
HubMed – depression

BASELINE DEPRESSION LEVELS DO NOT AFFECT EFFICACY OF COGNITIVE-BEHAVIORAL SELF-HELP TREATMENT FOR INSOMNIA.

Filed under: Depression Treatment

Depress Anxiety. 2012 Oct 18;
Lancee J, van den Bout J, van Straten A, Spoormaker VI

BACKGROUND: Cognitive-behavioral therapy can effectively treat insomnia (CBT-I). Randomized controlled trials have shown efficacy of self-help CBT-I, but unclear is whether excluding depressive patients boosted treatment effects. METHOD: We administered unsupported self-help CBT-I to insomnia patients with low and high depression levels. Based on the validated Centre of Epidemiological Studies-Depression (CES-D) scale, the internet-recruited sample (N = 479) was divided into three groups: low depression scores (n = 198), mild depression scores (n = 182), and high depression scores (n = 99). Follow-ups were 4 and 18 weeks after completion of the treatment. RESULTS: At 4-week follow-up, all groups had a similar amelioration on the primary sleep measures (d = 0.1-0.7; P < 0.05) and the secondary insomnia ratings (d = 1.2; P < 0.001). The only difference was that the high/mild depression groups had a steeper reduction in depression (d = 1.0-1.1; P < 0.001) and anxiety scores (d = 0.7-0.8; P < 0.001) than the low depression group (depression and anxiety: d = 0.3; P < 0.01), possibly due to floor effects in the latter group. The observed effects were sustained at the 18-week follow-up. CONCLUSIONS: This study showed that CBT-I is effective regardless of baseline depression levels. Treating the combination of insomnia and depression is an extra challenge since it is associated with increased sleep problems. These data may help us understand the relationship between insomnia and depression and indicate that self-help CBT-I may be a promising addition to regular depression treatment. HubMed – depression

Shifting from hypoxia to hyperoxia to assess the peripheral chemosensory drive of ventilation.

Filed under: Depression Treatment

Adv Exp Med Biol. 2012; 758: 137-42
Zapata P, Larraín C, Reyes EP, Fernández R

The study of the initial effects of a sudden and brief replacement of air by pure oxygen has been proposed as a tool (Dejours’ test) to determine the tonic influence that arterial (peripheral) chemoreceptors were exerting upon ventilation under previous normoxic conditions. Therefore, the acute ventilatory response to transient hyperoxia should be used to assess the level of hypoxic chemosensory drive. In spontaneously ventilated pentobarbitone-anesthetized cats, we observed that the degree of ventilatory depression provoked by hyperoxia was correlated to the degree of previous hypoxia. Minimal tidal volumes (V(T)) or transient apnea were reached between second to fourth cycles after switching from 5% to 100% O(2) breathing. Continuous recordings of chemosensory discharges from one carotid (sinus) nerve allowed correlation of the falls in frequency of chemosensory discharges to the degree of hyperoxia-induced ventilatory depression and provided an accurate measure of the prevailing chemosensory drive of ventilation exerted during hypoxic steady-state conditions.
HubMed – depression

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