A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients

作者：Kangas Maria^*; Milross Chris; Taylor Alan; Bryant Richard A

来源：Psycho-Oncology, 2013, 22(7): 1665-1673.

DOI：10.1002/pon.3208

• CBT
• head and neck cancer
• posttraumatic stress
• depression
• oncology
• psychotherapy

ObjectiveHead and neck cancer (HNC) patients have a high incidence of cancer-related posttraumatic stress disorder (PTSD) and other anxiety and depressive disorders. We report the results from the first pilot randomized controlled trial in which the efficacy of an early cognitive-behavioral therapy (CBT) program was compared with a non-directive supportive counseling (SC) intervention in reducing PTSD, general anxiety and depressive symptoms, and improving perceived quality of life in newly diagnosed, distressed HNC patients undergoing radiotherapy. %26lt;br%26gt;Patients and methodsThirty-five HNC patients (mean age=54.8years; 80% males) with elevated levels of PTSD, depression or anxiety were randomized to seven individual sessions of a multi-modal CBT or non-directive SC, concurrent with patients%26apos; radiotherapy. The SC intervention provided non-directive counseling support. PTSD, anxiety and depressive symptoms (primary outcomes), and cancer-related appraisals and quality of life (secondary outcomes) were assessed pre-intervention (baseline), 1month, 6months and 12months post-intervention by diagnostic clinical interviews and validated self-report questionnaires. %26lt;br%26gt;ResultsThe CBT and SC interventions were found to be equal in their effects in reducing PTSD and anxiety symptoms both in the short and longer term. However, up to 67% of patients in the CBT program no longer met clinical or sub-clinical PTSD, anxiety and/or depression by 12months post-treatment compared with 25% of patients who received SC. %26lt;br%26gt;ConclusionFindings indicate that the early provision of psychotherapy has utility in reducing PTSD, anxiety and depressive symptoms, and preventing chronic psychopathology in distressed HNC patients.

• 出版日期2013-7