 |
|
Depression in older cancer patients can be effectively treated with collaborative approach
October 21, 2009Treatment can take place in primary-care settings
Depression in older cancer patients can be effectively treated with collaborative approach in primary-care settings
Depression in older cancer patients is very common, and has debilitating effects on their quality of life both during and after treatment. University of Washington (UW) researchers are showing that there are ways to better this situation.
"Little is known about the optimal approach to treating depression in this population, and older cancer patients are less likely to be treated for their depression than are younger cancer patients," said Dr. Jesse Fann, University of Washington associate professor of psychiatry and behavioral sciences. Fann is the director of psychiatric services at the Seattle Cancer Care Alliance, and an investigator in the Clinical Research Division at the Fred Hutchinson Cancer Research Center in Seattle.
Fann and his colleagues evaluated the effectiveness in older, depressed cancer patients of an intervention called Improving Mood-Promoting Access to Collaborative Treatment (IMPACT), in comparison to a similar set of patients receiving usual care. All participants had either major depression or a type of chronic depression called dysthymia, or a combination of both.
IMPACT participants worked with a depression care manager in their primary-care clinic for up to a year. Under the supervision of the patient's primary-care provider and a psychiatrist, the care manager offered the patient support in taking anti-depressants if prescribed by the primary-care provider, education about depression, care coordination and structured counseling sessions that helped the patient engage in pleasant activities and that taught problem-solving skills.
The intervention was tested in 18 primary-care clinics in 5 states. The clinics served a variety of different socio-economic, geographic, and ethnic populations.
At the end of six months, 55 percent of the patients in the IMPACT group and 34 percent of the usual care participants showed a 50 percent or greater reduction in their depression symptoms. The IMPACT participants also had higher remission rates from depression, more depression-free days, less fatigue, a better quality of life, less functional impairment and fewer thoughts of death. Many of these benefits persisted during the one-year follow up period after the intervention was completed.
"Among the functional impairments older cancer patients can experience with depression are fatigue and thinking problems, such as forgetfulness, feeling mentally slowed down, and having difficulty concentrating or solving problems. Decisions that used to be straightforward or easy for them have become challenging," Fann explained.
Based on their findings, the researchers concluded that the IMPACT collaborative care program is feasible and more effective than standard care in managing depression among older cancer patients in primary-care, and is widely applicable.
"The IMPACT intervention can be successfully provided in diverse types of primary-care settings in various locations, and not just at specialized cancer centers. It can literally double the likelihood that the patient's depression will improve over time," said Dr. Jurgen Unutzer, UW professor of psychiatry and behavioral sciences and a co-investigator on the study with Fann and Dr. Ming-Yu Fan, UW research assistant professor of psychiatry and behavioral sciences.
The results were published today, Oct. 20, in a supplement of the Journal of General Internal Medicine on cancer survivorship care in primary-care.
Obtaining effective treatment for depression is vital, explained Fann, because of the serious, troubling effects depression has on many cancer patients: A depressed person may feel less motivated to exercise or eat well, to carry out treatment plans or be an active participant in their care. The risk of suicide is twice as high among older cancer patients compared to the general population, and the risk is even higher with older age. Some depressed patients question if cancer treatment is worth it, even if they don't plan to end their lives. Patients may rebuff family and friends, and feel incapable of making arrangements for the future.
"Depression may persist after the cancer is successfully treated or in remission. They have survived the disease, but still can't re-engage in life." Unutzer added. "Patients may feel unable to enjoy or make use of the time that has been added to their life."
The elderly are the largest segment of our population with cancer, and older cancer patients are becoming a significant segment of primary care practice, Fann and Unutzer said. By supporting depression care in primary-care settings, they added, health-care providers can help older cancer patients truly benefit from advances in cancer treatment by improving their quality of life.
Their suggestion to older cancer patients: "If you have depression, you don't have to 'just live with it.' Treatment may increase the odds that you will feel less tired and feel more like getting on with life. You dealt with cancer, and you can do something about depression."
University of Washington
"Little is known about the optimal approach to treating depression in this population, and older cancer patients are less likely to be treated for their depression than are younger cancer patients," said Dr. Jesse Fann, University of Washington associate professor of psychiatry and behavioral sciences. Fann is the director of psychiatric services at the Seattle Cancer Care Alliance, and an investigator in the Clinical Research Division at the Fred Hutchinson Cancer Research Center in Seattle.
Fann and his colleagues evaluated the effectiveness in older, depressed cancer patients of an intervention called Improving Mood-Promoting Access to Collaborative Treatment (IMPACT), in comparison to a similar set of patients receiving usual care. All participants had either major depression or a type of chronic depression called dysthymia, or a combination of both.
IMPACT participants worked with a depression care manager in their primary-care clinic for up to a year. Under the supervision of the patient's primary-care provider and a psychiatrist, the care manager offered the patient support in taking anti-depressants if prescribed by the primary-care provider, education about depression, care coordination and structured counseling sessions that helped the patient engage in pleasant activities and that taught problem-solving skills.
The intervention was tested in 18 primary-care clinics in 5 states. The clinics served a variety of different socio-economic, geographic, and ethnic populations.
At the end of six months, 55 percent of the patients in the IMPACT group and 34 percent of the usual care participants showed a 50 percent or greater reduction in their depression symptoms. The IMPACT participants also had higher remission rates from depression, more depression-free days, less fatigue, a better quality of life, less functional impairment and fewer thoughts of death. Many of these benefits persisted during the one-year follow up period after the intervention was completed.
"Among the functional impairments older cancer patients can experience with depression are fatigue and thinking problems, such as forgetfulness, feeling mentally slowed down, and having difficulty concentrating or solving problems. Decisions that used to be straightforward or easy for them have become challenging," Fann explained.
Based on their findings, the researchers concluded that the IMPACT collaborative care program is feasible and more effective than standard care in managing depression among older cancer patients in primary-care, and is widely applicable.
"The IMPACT intervention can be successfully provided in diverse types of primary-care settings in various locations, and not just at specialized cancer centers. It can literally double the likelihood that the patient's depression will improve over time," said Dr. Jurgen Unutzer, UW professor of psychiatry and behavioral sciences and a co-investigator on the study with Fann and Dr. Ming-Yu Fan, UW research assistant professor of psychiatry and behavioral sciences.
The results were published today, Oct. 20, in a supplement of the Journal of General Internal Medicine on cancer survivorship care in primary-care.
Obtaining effective treatment for depression is vital, explained Fann, because of the serious, troubling effects depression has on many cancer patients: A depressed person may feel less motivated to exercise or eat well, to carry out treatment plans or be an active participant in their care. The risk of suicide is twice as high among older cancer patients compared to the general population, and the risk is even higher with older age. Some depressed patients question if cancer treatment is worth it, even if they don't plan to end their lives. Patients may rebuff family and friends, and feel incapable of making arrangements for the future.
"Depression may persist after the cancer is successfully treated or in remission. They have survived the disease, but still can't re-engage in life." Unutzer added. "Patients may feel unable to enjoy or make use of the time that has been added to their life."
The elderly are the largest segment of our population with cancer, and older cancer patients are becoming a significant segment of primary care practice, Fann and Unutzer said. By supporting depression care in primary-care settings, they added, health-care providers can help older cancer patients truly benefit from advances in cancer treatment by improving their quality of life.
Their suggestion to older cancer patients: "If you have depression, you don't have to 'just live with it.' Treatment may increase the odds that you will feel less tired and feel more like getting on with life. You dealt with cancer, and you can do something about depression."
University of Washington
Depression Current Events and Depression News RSSMother's Depression a Risk Factor in Childhood Asthma Symptoms, Study Suggests
Asthma symptoms can worsen in children with depressed mothers, according to research from Johns Hopkins Children's Center published online in the Journal of Pediatric Psychology.
Dispensing prescription drugs in 3-month supplies reduces drug costs by a third
Purchasing prescription drugs in a three-month supply rather than a one-month supply has long been regarded as a way to reduce the cost of drugs for patients and third-party payers. New research from the University of Chicago quantifies the savings for the first time.
New Down syndrome treatment suggested by Stanford/Packard study in mice
At birth, children with Down syndrome aren't developmentally delayed. But as they age, these kids fall behind. Memory deficits inherent in Down syndrome hinder learning, making it hard for the brain to collect experiences needed for normal cognitive development.
At-risk college students reduce HBP, anxiety, depression through Transcendental Meditation
The Transcendental Meditation technique may be an effective method to reduce blood pressure, anxiety, depression, and anger among at-risk college students, according to a new study to be published in the American Journal of Hypertension, December 2009.
Teens' mental health affects how long they stay in school, new study shows
Queen's University researcher Steven Lehrer has won a prestigious international award in recognition of his contributions to health economics.
Ethnic pride may boost African-American teens' mental health
Most adolescents who belong to an ethnic minority group wrestle not only with their self-esteem (like most teens), but also with identity issues unique to their ethnic group, such as dealing with social stigma. A new study tells us that young people's ethnic pride may affect their mental health.
Faulty body clock may make kids bipolar
Malfunctioning circadian clock genes may be responsible for bipolar disorder in children. Researchers writing in the open access journal BMC Psychiatry found four versions of the regulatory gene RORB that were associated with pediatric bipolar disorder.
Women with asthma feel worse
Women with asthma are more anxious, find it harder to sleep and are more tired during the day than their male counterparts, but nevertheless tend to be better at following their treatment.
Connection between depression and osteoporosis detailed by Hebrew University researchers
Research carried out among thousands of people has shown a clear connection between depression and a loss of bone mass, leading to osteoporosis and fractures.
Reduced muscle strength associated with risk for Alzheimer's
Individuals with weaker muscles appear to have a higher risk for Alzheimer's disease and declines in cognitive function over time, according to a report in the November issue of Archives of Neurology, one of the JAMA/Archives journals.
More Depression Current Events and Depression News Articles
 |
The Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness by Mark Williams (Author), John Teasdale (Author), Zindel Segal (Author), Jon Kabat-Zinn (Author) If you’ve ever struggled with depression, take heart. Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life experiences, can help you break the cycle of chronic unhappiness once and for all. In The Mindful Way through Depression, four uniquely qualified experts explain why our usual attempts to “think” our way out of a bad mood or just “snap out of it” lead us deeper into the downward spiral. Through insightful lessons drawn from both Eastern meditative traditions and cognitive therapy, they demonstrate how to sidestep the mental habits that lead to despair, including rumination and self-blame, so you can face life’s challenges with greater resilience. Jon Kabat-Zinn gently and encouragingly narrates the accompanying CD of guided... |
 |
The Cognitive Behavioral Workbook for Depression: A Step-by-step Program (Workbook) by William J. Knaus (Author), Albert Ellis (Foreword) In the 1950s, Albert Ellis pioneered a form of psychotherapy that combined ways of detecting and changing irrational thoughts with techniques for replacing negative behaviors with positive ones. This type of cognitive behavioral therapy, called rational emotive behavior therapy (REBT) by Ellis, proved especially effective at relieving problems like anger, anxiety, and depression. In this book author William Knaus, a close associate of Ellis, develops the best REBT techniques into a powerful and comprehensive self-help workbook for the treatment of depression. Following in New Harbinger’s tradition, this workbook is written in an easy-to-use, step-by-step format. It offers you powerful strategies for overcoming depression in simple, direct language, amply illustrated with stories... |
 |
Talking to Depression: Simple Ways To Connect When Someone In Your Life Is Depressed by Claudia J. Strauss (Author), Martha Manning (Foreword) When someone suffers from depression, friends and family members naturally want to help-but too often their good intentions come out all wrong. This practical, compassionate guide helps readers understand exactly what their loved one is going through, and why certain approaches help and others have the potential to do damage. Talking to Depression offers specific advice on what to do and what not to do-and what to say and what not to say-to avoid frustration and give the kind of caring, effective support that will make a difference. |
 |
Self-Coaching: The Powerful Program to Beat Anxiety and Depression, 2nd Edition, Completely Revised and Updated by Joseph J. Luciani (Author) The simple, untold truth about anxiety and depression is that they are habits of insecurity—and, like all habits, they can be broken. In this new edition of the highly successful Self-Coaching, Dr. Joseph Luciani shows you how to change your way of thinking and develop a healthy, adaptive way of living through his proven Self-Talk strategy for coaching yourself back to health. |
 |
Undoing Depression: What Therapy Doesn't Teach You and Medication Can't Give You by Richard O'Connor (Author) Like heart disease, says psychotherapist Richard O'Connor, depression is fueled by complex and interrelated factors: genetic, biochemical, environmental. In this refreshingly sensible book, O'Connor focuses on an additional factor often overlooked: our own habits. Unwittingly we get good at depression. We learn how to hide it, how to work around it. We may even achieve great things, but with constant struggle rather than satisfaction. Relying on these methods to make it through each day, we deprive ourselves of true recovery, of deep joy and healthy emotion. UNDOING DEPRESSION teaches us how to replace depressive patterns with a new and more effective set of skills. We already know how to "do" depression-and we can learn how to undo it. With a truly holistic approach that... |
 |
Depression: A Stubborn Darkness--Light for the Path (VantagePoint Books) by Edward T. Welch (Author) Depression: A Stubborn Darkness is Dr. Edward T. Welch's latest release in a series of ground-breaking best-selling counseling books that include When People Are Big and God is Small, Blame It on the Brain?, Addictions: A Banquet in the Grave. Now in its third printing, Welch continues to further his reputation as an author who can speak to general consumers in a language they intuitively connect with on a deeply personal level. Endorsed by Joni Eareckson Tada, and Bob Lepine of FamilyLife, this book is targeted to the 18 million adult Americans who struggle with depression. Compassionate and compelling, the book lays out issues and answers with Welch's world view that faith needs to be interlaced with therapies and medication for conditions categorized as strictly clinical. The author... |
 |
Depression: Out of the Shadows Many Americans are keeping an important, possibly deadly secret: depression. Approximately 15 million American adults live with this devastating disease which affects all age, race, gender, and socioeconomic groups. Through the voices and stories of people living with depression and interviews with scientists, Depression: Out of the Shadows provides a portrait of the disease never before seen on American television. |
 |
Overcoming Depression One Step at a Time: The New Behavioral Activation Approach to Getting Your Life Back (New Harbinger Self-Help Workbook) by Michael E., Ph.D. Addis (Author), Christopher R. Martell (Author) Learn breakthrough self-activation techniques to: ·Become more engaged with your life ·Enjoy daily activities ·Feel able to face challenges ·Stop avoiding social situations ·Feel strong and competent again ·Conquer the obstacles that keep depression going ·Stop making decisions based on your moods ·Get back on track with your life goals ·Recognize the habits and patterns that fuel your depression Achieve medication-free recovery Behavioral activation therapy offers effective, fast relief from depression. This powerful and progressive therapy steers away from the idea that depression symptoms represent an illness or weakness. Instead, depression is merely a signpost pointing directly at the things that need to change in one's life. Its engaging... |
 |
Depression Fallout: The Impact of Depression on Couples and What You Can Do to Preserve the Bond by Anne Sheffield (Author) What happens to love when a partner is depressed? Is your partner's depression undermining your happiness as a couple? After blaming yourself, losing your self-esteem, and getting angry, you may feel like walking away -- even if you're still in love. With 19 million Americans suffering from depression, you are not alone in your unhappiness. And no one knows what you're going through better than Anne Sheffield, who coined the phrase "depression fallout" in her first book, How You Can Survive When They're Depressed, to describe the emotional toll of depression on spouses, parents, lovers, and children.Sharing essential information, compassion, and street-smart advice, Anne Sheffield tells you: What you need to know about your partner's mental health and what to do about... |
 |
Amoryn Depression Anxiety Relief (60 Caps) by BioNeurix AMORYN works by increasing the levels of all four of the brain's "feel good" neurotransmitters. By providing an all-natural boost to serotonin, dopamine, norepinephrine, and GABA, the ingredients in AMORYN can help you feel happy, calm, and confident.serotonin levels. As a precursor to serotonin, 5-HTP provides the brain with the "building blocks" needed to produce more serotonin naturally. |
| © 2009 BrightSurf.com |