Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.662562
Title: The management of major depressive disorder in cancer patients : a randomised trial
Author: Strong, V. A.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2008
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Abstract:
MDD in cancer patients demands attention as it is a major determinant of quality of life, is associated with non-adherence to treatment, with greater functional impairment or disability, with increased medical costs and is associated with suicide and with an increased risk of death from all causes. However, there is only limited evidence to inform its treatment. In this thesis I describe the development of a nurse-delivered psychiatrist supervised multi-component intervention (problem-solving therapy, coordination of antidepressant drug treatment with primary care, and active monitoring and follow up of the patient’s progress) for the management of MDD in cancer patients and its evaluation in a randomised controlled clinical trial (RCT). 200 Outpatients with varied cancer diagnoses and stages, meeting criteria for MDD were randomly assigned in a single-centre two-arm RCT to receive either optimised usual care or optimised usual care plus the intervention. A clinically and statistically significantly better outcome was observed for patients who had received the intervention (difference of adjusted mean Symptom Check-List-20 score of 0.34; 95% CI 0.13 to 0.55) three months after trial entry. This trial provides evidence of efficacy. Further research is needed to test the efficacy of multi-component interventions for patients with poor prognosis cancers and to test the effectiveness of the intervention in normal clinical practice in a range of settings.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.662562  DOI: Not available
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