A controlled trial of group cognitive behaviour therapy for Irish breast cancer patients

The aim of this study was to evaluate a manualized cognitive behavioral group intervention for early-stage breast cancer patients. Sixty-nine women were recruited at an Irish specialist oncology hospital and assigned to a 6-week cognitive behavior therapy (CBT) program or an educational control group. Participants were assessed at baseline, 6 weeks, and 6-month follow-up. Groups × Time (2 × 3) ANOVAs showed that the program did not lead to greater improvement on standardized measures of coping, quality of life, or mood compared with the control group. Regression analyses showed that maladaptive coping and distress at baseline were predictive of psychological adjustment at follow-up. Level of distress was also predictive of quality of life at follow-up. Repeated measures ANOVAs of data from cases in the intervention group showed that patients who completed the program showed significant improvement in problem severity, impact of problems, coping ability, and goal attainment from pre- to posttreatment, and these gains were maintained at follow-up for problem severity and impact of problems, but not for coping ability or goal attainment. Participation in the program did not lead to less health service usage during the period from baseline to follow-up, compared with the educational control group. A controlled trial provided limited evidence for the effectiveness of brief cognitive behavior intervention in enhancing psychological adjustment of early-stage breast cancer patients with nonclinically significant levels of psychological distress. Future research should evaluate the effectiveness of the program for patients with elevated levels of psychological distress and limited coping resources.Other funderSaint Luke’s Institute of Cancer ResearchIrish Research Council for Social and Human SciencesUCD Seed Funding SchemeIrish Cancer SocietyAuthor has checked copyrightkpw9/12/1

Assessing Depression in Primary Care with the PHQ-9: Can It Be Carried Out over the Telephone?

BACKGROUND: Telephone assessment of depression for research purposes is increasingly being used. The Patient Health Questionnaire 9-item depression module (PHQ-9) is a well-validated, brief, self-reported, diagnostic, and severity measure of depression designed for use in primary care (PC). To our knowledge, there are no available data regarding its validity when administered over the telephone. OBJECTIVE: The aims of the present study were to evaluate agreement between self-administered and telephone-administered PHQ-9, to investigate possible systematic bias, and to evaluate the internal consistency of the telephone-administered PHQ-9. METHODS: Three hundred and forty-six participants from two PC centers were assessed twice with the PHQ-9. Participants were divided into 4 groups according to administration procedure order and administration procedure of the PHQ-9: Self-administered/Telephone-administered; Telephone-administered/Self-administered; Telephone-administered/Telephone-administered; and Self-administered/Self-administered. The first 2 groups served for analyzing the procedural validity of telephone-administered PHQ-9. The last 2 allowed a test–retest reliability analysis of both self- and telephone-administered PHQ-9. Intraclass correlation coefficient (ICC) and weighted κ (for each item) were calculated as measures of concordance. Additionally, Pearson's correlation coefficient, Student's t-test, and Cronbach's α were analyzed. RESULTS: Intraclass correlation coefficient and weighted κ between both administration procedures were excellent, revealing a strong concordance between telephone- and self-administered PHQ-9. A small and clinically nonsignificant tendency was observed toward lower scores for the telephone-administered PHQ-9. The internal consistency of the telephone-administered PHQ-9 was high and close to the self-administered one. CONCLUSIONS: Telephone and in-person assessments by means of the PHQ-9 yield similar results. Thus, telephone administration of the PHQ-9 seems to be a reliable procedure for assessing depression in PC