Other Medical Conditions

CT has been tested in other medically ill patient populations, with outcomes such as improved adjustment to illness, increased ability to cope with stress, and better health-related quality of life. Few studies have tested the efficacy of CT for comorbid depression in a defined medical illness. For example, the Lustman et al. (1998b) study described earlier is so far the only published trial of CT for depression in patients with diabetes.

Most of the clinical trials published so far have been small, single-site studies, and only some have demonstrated favorable outcomes. In one study, for example, stroke patients were randomly assigned to 10 sessions of CT, an attention control intervention, or usual care. No significant differences were found on posttreatment measures of depression, functional status, or satisfaction with care (Lincoln & Flannaghan, 2003). Sharpe et al. (2001) randomly assigned patients with arthritis to eight sessions of CT or to usual care. The CT group scored significantly lower on the Hospital Anxiety and Depression Scale (HADS) at 6 months. In contrast, Parker et al. (2003) reported that a combination of CT and antidepressants for depression in patients with arthritis was not more efficacious than antidepressants alone.

Given et al. (2004) randomly assigned patients with malignant tumors who were undergoing chemotherapy to a 10 sessions of CT or to usual care. Severely depressed patients derived greater benefit from CT than those who were mildly depressed. In contrast, Trask, Paterson, Griffith, Riba, and Schwartz (2003) randomized patients with malignant melanoma to four sessions of CT or to a control group. There were no significant differences in emotional distress on the posttreatment outcome assessments.

Mohr et al. (2000,2001) conducted a series of small treatment trials for depression in patients with multiple sclerosis. In one study, patients were randomly assigned to 8 weeks of telephone-administered CT or to usual care. Posttreatment scores on the Profile of Mood States Depression subscale were significantly lower in the CT group than the control group (Mohr et al., 2000). In another study, patients were randomly assigned to 16 weeks of CT, supportive-expressive group therapy, or sertraline. Patients who had received CT or sertraline were significantly less depressed at the post-treatment assessment than those who had received supportive therapy (Mohr et al., 2001).

Finally, in a large, randomized trial, Simon et al. (2004), compared telephone-administered CT combined with case management, case management alone, and usual care for primary care patients who were starting antidepressant therapy. Depression outcomes were significantly better in the CT plus case management group than in the usual care group.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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