Talk therapy can help treat depression symptoms in patients with terminal cancer, according to Japanese researchers who reviewed the results of six studies that included a total of 517 patients with incurable cancer and depression.
The primary type of depression treatment for these patients was supportive expressive group therapy, in which they were encouraged to discuss their deepest fears and feelings and to help each other cope with them.
The review authors found that the benefits of this kind of treatment were only slightly less than those found in clinical trials of antidepressant drugs in general patient populations.
"Psychotherapy can be a promising treatment for ameliorating depressive states in advanced cancer patients if they prefer to receive it," said review lead author Tatsuo Akechi, an associate professor of psychiatry and cognitive-behavioral medicine at the Nagoya City University Graduate School of Medical Sciences.
However, Akechi and his colleagues found that psychotherapy did not significantly improve patient anxiety. This may be because there were too few patients to give enough statistical power to demonstrate an effect, Akechi suggested.
The researchers didn't examine whether psychotherapy could improve survival or response to cancer treatment. The review appears in the current issue of the journal The Cochrane Library.
"The key finding is that psychotherapy for depression for gravely ill cancer patients works," David Spiegel, associate chair of psychiatry and behavioral sciences at Stanford University School of Medicine and an expert on therapy in cancer patients, said in a prepared statement. He wasn't involved in the review but was one of the lead investigators on one of the studies included in the review.
Spiegel said that many doctors don't look for depression in patients with advanced cancer, or they consider it a normal and untreatable response among dying patients. Spiegel noted that only about 25 percent of patients with terminal cancer suffer depression due to their situation, which is different than the grief, sadness and anger associated with the thought of dying.
"Depression and existential dread or sadness is not the same thing. Patients with depression feel hopeless, helpless and worthless. They feel like a burden to others," Spiegel said.
More information
The U.S. National Cancer Institute has more about depression.
SOURCE: Center for the Advancement of Health, news release, April 15, 2008
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