Pitceathly, C., Maguire, P., Fletcher, I., Parle, M., Tomenson, B., & Creed, F. (2009). Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients? A randomised controlled trial. Annals of Oncology, 20, 928–934.

To test the hypothesis that a brief intervention would be superior to usual care to prevent anxiety or depressive disorders among newly diagnosed patients with cancer

The structured intervention was based on cognitive behavioral therapy geared toward coping and exploring beliefs and thoughts about illness. The first session was 90 minutes in person with a therapist, followed by two 45-minute sessions two and six weeks later via telephone.

• The sample was comprised of 465 patients with cancer.
• Mean patient age was 51.4 years ± 13.04.
• The sample was 69% female and 31% male.
• The most common diagnoses were breast cancer, lymphoma, and gynecologic cancers.
• Patients were excluded if they had an anxiety or depressive disorder, were taking antidepressant or anxiolytic medication, or were receiving psychological intervention.
• At baseline, 59.6% of patients were deemed to be at high risk for development of anxiety or depressive disorders.
• The majority of patients were receiving either chemotherapy or radiotherapy alone.
• Most (70%–77%) patients were married or cohabitating.

• Single site
• Outpatient setting
• Manchester, England, United Kingdom

Active treatment phase

A randomized controlled trial design was used.

• Structured clinical interview for DSM-III-R (SCII) to identify any episode of anxiety or depressive disorder
• Hospital Anxiety and Depression Scale (HADS)
• Concerns checklist: 14-item checklist of physical, practical, relationship, and existential concerns rated on a five-point scale

By the six-month time point, approximately 27% of participants were lost to follow-up or had dropped out of the study for various reasons. Those variables found to predict drop-out were age, gender, previous psychiatric history, and concerns score, some of which were the same variables reported to be predictive of developing an anxiety or depressive disorder.

At the 12-month follow-up, there was no difference between groups. In patients at high risk for developing an anxiety or depressive disorder, those in the intervention group were less likely to develop a disorder (p = 0.05). There was no difference in findings based on the timing of the intervention (immediate – within one week of starting treatment, versus delayed – eight weeks after starting treatment).

The brief intervention studied may have potential for preventing development of anxiety or depressive disorders only in those patients who were at initial high risk for development of those disorders.

• The study had no attentional control.
• The study had increased risk of bias because patients self-selected to either the intervention or control group.