Combined therapy versus usual care for the treatment of depression in oncologic patients: a randomized controlled trial

Objective: To compare narrative therapy (NT) plus escitalopram versus escitalopram plus usual care on quality of life and depressive symptomatology of depressed patients with oncologic disease. Methods: A total of 72 subjects (mean age 54.6 years), predominantly female with non-metastatic breast, lung and colon cancer and depressive disorder (DSM-IV-TR) were randomized to receive treatment with NT plus escitalopram (n = 39) or escitalopram (10-20 mg QD) plus usual care (n = 33). Main endpoints were improvement in dimensions of quality of life measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 and reduction of depressive symptoms using the Hospital Anxiety and Depression Scale at weeks 12 and 24. Results: The combined therapy group showed significantly greater improvement in all the functioning dimensions (p<0.01), pain scale (p = 0.02), global health (p = 0.02), and global quality of life (p = 0.007) at weeks 12 and 24. There were no statistically significant differences in depressive symptomatology between the groups. From week 12 to week 24 study retention was higher in the combined treatment group (p = 0.01). Conclusions: Brief NT in combination with escitalopram was superior to usual care and escitalopram in improving functioning dimensions of quality life. Copyright (C) 2010 John Wiley & Sons, Ltd.