Randomized Control Trial to Test a Computerized Psychosocial Cancer Assessment and Referral Program: Methods and Research Design.

Randomized Control Trial to Test a Computerized Psychosocial Cancer Assessment and Referral Program: Methods and Research Design.

Filed under: Depression Treatment

Contemp Clin Trials. 2013 Feb 6;
O’Hea EL, Cutillo A, Dietzen L, Harralson T, Grissom G, Person S, Boudreaux ED

The National Cancer Coalition Network, National Cancer Institute, and American College of Surgeons all emphasize the need for oncology providers to identify, address, and monitor psychosocial needs of their patients. The Mental Health Assessment and Dynamic Referral for Oncology (MHADRO) is a patient-driven, computerized, psychosocial assessment that identifies, addresses, and monitors physical, psychological, and social issues faced by oncology patients. This paper presents the methodology of a randomized controlled trial (RCT) that tested the impact of the MHADRO on patient outcomes at 2, 6, and 12 months. Patient outcomes including overall psychological distress, depression, anxiety, functional disability, and use of psychosocial resources will be presented in future publications after all follow-up data is gathered. Eight hundred and thirty six cancer patients with heterogeneous diagnoses, across three comprehensive cancer centers in different parts of the United States, were randomized to the MHADRO (intervention) or an assessment-only control group. Patients in the intervention group were provided detailed, personalized reports and, when needed, referrals to mental health services; their oncology provider received detailed reports designed to foster clinical decision making. Those patients who demonstrated high levels of psychosocial problems were given the option to authorize that a copy of their report be sent electronically to a “best match” mental health professional. Demographic and patient cancer-related data as well as comparisons between patients who were enrolled and those who declined enrollment are presented. Challenges encountered during the RCT and strategies used to address them are discussed.
HubMed – depression

Cognitive functioning in psychiatric disorders following deep brain stimulation.

Filed under: Depression Treatment

Brain Stimul. 2013 Jan 29;
Bergfeld IO, Mantione M, Hoogendoorn ML, Denys D

BACKGROUND: Deep brain stimulation (DBS) is routinely used as a treatment for treatment-refractory Parkinson’s disease and has recently been proposed for psychiatric disorders such as Tourette syndrome (TS), obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). Although cognitive deterioration has repeatedly been shown in patients with Parkinson’s disease following DBS, the impact of DBS on cognitive functioning in psychiatric patients has not yet been reviewed. OBJECTIVE: Reviewing the available literature on cognitive functioning following DBS in psychiatric patients. METHODS: A systematic literature search in PubMed, EMBASE and Web of Science, last updated in September 2012, found 1470 papers. Abstracts were scrutinized and 26 studies examining cognitive functioning of psychiatric patients following DBS were included on basis of predetermined inclusion criteria. RESULTS: Twenty-six studies reported cognitive functioning of 130 psychiatric patients following DBS (37 TS patients, 56 OCD patients, 28 MDD patients, 6 patients with Alzheimer’s disease, and 3 patients with other disorders). None of the studies reported substantial cognitive decline following DBS. On the contrary, 13 studies reported cognitive improvement following DBS. CONCLUSION: Preliminary results suggest that DBS in psychiatric disorders does not lead to cognitive decline. In selected cases cognitive functioning was improved following DBS. However, cognitive improvement cannot be conclusively attributed to DBS since studies are hampered by serious limitations. We discuss the outcomes in light of these limitations and offer suggestions for future work.
HubMed – depression

Is the Blunted Blood Pressure Reactivity in Dysphoric Individuals Related to Attenuated Behavioral Approach?

Filed under: Depression Treatment

Int J Psychophysiol. 2013 Feb 5;
Schwerdtfeger AR, Gerteis AK

Depressive symptoms have been related to autonomic nervous system dysregulation. Recent research found attenuated cardiovascular reactivity to self-relevant tasks. The aim of this study was to examine whether blunted blood pressure reactivity in dysphoric individuals is moderated by impaired effort mobilization and behavioral approach. Seventy-five individuals were instructed to sing a song in front of a camera. Depressive symptoms, blood pressure, heart rate, and heart rate variability as well as subjective and other-rated indicators of behavioral approach were recorded. Depressive symptoms were positively correlated with heart rate and inversely associated with heart rate variability during baseline. Moreover, higher depression scores were accompanied by attenuated systolic blood pressure reactivity during singing, thus supporting previous research. This finding was neither mediated by subjective nor other-rated indicators of behavioral approach. Although confirming recent evidence of blunted blood pressure reactivity and altered autonomic baseline function in dysphoric individuals, the findings call for further research on the role of behavioral approach in depression-related blunted physiological reactivity.
HubMed – depression

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