The Impact of CBT on Depression and Anxiety in Breast Cancer Patients

Transcript

1. THE IMPACT OF CBT ON 
 DEPRESSION AND ANXIETY IN BREAST CANCER PATIENTS
2. BACKGROUND INFO BREAST CANCER
3. 50% Breast cancer patients who experience depression, 
 anxiety, or both within the first year of diagnosis.
4. The number of women currently living who have 
 had (or currently have) a diagnosis of breast cancer. 2,747,459
5. 1 in 8 women will receive a breast cancer 
 diagnosis during their life.
6. BACKGROUND INFO CBT
7. COGNITIVE BEHAVIORAL THERAPY An efficacious treatment that can be highly individualized and comes in many different forms. Psychotherapy involves addressing maladaptive behaviors as well as their corresponding thoughts. The focus is on the behavioral as well as the cognitive component in order to better understand how the disease is impacting the patient.
8. COGNITIVE BEHAVIORAL THERAPY has been used in nearly every area of mental health as well as some medical conditions outside of mental health.
9. RATIONALE
10. 1 Because CBT can be custom built for an individual patient and allows room for the therapist to use good clinical judgment in order to treat the patient, 
 it seems to be an ideal treatment option for complex diseases that may not always have the same prognosis 
 for each patient.
11. 2 Breast cancer, depending on size 
 of the tumor, stage, current and previous medical and psychological conditions, age, overall health, social support, and numerous other factors, seems to be a prime example of 
 a complex medical condition.
12. 3 Evidence has been provided that CBT alleviates distress and pain 
 in breast cancer patients.
13. 4 Many patients with breast cancer develop mental health issues as a result of their diagnosis and condition, especially depression and anxiety. CBT has been shown to be effective in treating depression and anxiety.
14. QUESTIONS
15. How do other treatment options 
 factor in? What specific components of CBT 
 make it ideal? What about other psychological 
 side effects and how to deal with those?
16. HYPOTHESIS
17. CBT will have a significant decrease 
 in depression and anxiety in breast cancer patients. The CBT group will be superior 
 to the care-as-usual (CAU) treatment group in terms of decreased depression 
 and anxiety symptoms.
18. What does CAU typically entail? Does CAU differ depending on setting? CAU-SPECIFIC 
 QUESTIONS
19. METHOD
20. SETTING Clinic + Hospital TIME Baseline, 3 months, 6 months and 12 months SAMPLE 18-55 years old; cut off at 55 to control for any potential cognitive decline RECRUITMENT Through local oncologist CBT SESSIONS 1-hour psycho-education session begins with family members; 1-hour session twice weekly for 8 weeks
21. DESIGN
22. This will be a clinical trial as there will be two groups – one receiving treatment and one not receiving treatment. At the end of the project, the two groups will be compared for differences.
23. GROUP 1
 CAU GROUP 2
 CBT This group will consist 
 of breast care patients that will be the “control” group. They will receive care as usual from their oncologist and other health care providers, 
 but not CBT. This group will receive 
 the CBT treatment previously outlined 
 as well as CAU.
24. Patients will be randomly divided into either group 
 by age and number of times receiving diagnosis 
 as well as prognosis/stage of cancer. RANDOMIZATION
25. A diagnosis of breast cancer within the past year; cannot be deemed immediately terminal. INCLUSION CRITERIA
26. No other imminent medical or psychological conditions such as a severe mental illness of chronic condition such as MS, Lupus, etc. This is to control for internal validity as the other conditions could be the driving force behind the depression and/or anxiety. EXCLUSION CRITERIA
27. OTHER QUESTIONS
28. What about current medications, such as SSRIs? What about the role of support systems? How does the role of coping strategies impact outcome?
29. MEASURES
30. BDI (Beck Depression Inventory) to assess 
 for depressive symptoms. ! BAI (Beck Anxiety Inventory) to assess 
 for anxiety symptoms. ! Both easy to administer and well-validated 
 in clinical settings.
31. Initial unstructured interviews by a trained and licensed psychologist will also be administered 
 to ensure no underlying psychopathology. ! An initial medical exam by a physician will also
 be conducted. ! A mixed-model (2 x 3) ANOVA will be conducted.
 2 groups: CBT, CAU 3 assessment points: 3, 6, 12 months
32. Q&A
33. THANK YOU.