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Does psychodynamic short-term psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial

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Abstract

The purpose of this study was to determine (a) the course of fatigue in depressed breast cancer patients, (b) the effect of a depression-focused individual psychodynamic psychotherapy on fatigue, and (c) the associations of fatigue with depression, quality of life and treatment-related variables. In a German multicentre randomized controlled trial in Leipzig and Mainz, depressed early breast cancer patients (UICC stage 0–III, age 18–70 years) were randomly assigned to a short-term psychodynamic psychotherapy (STPP, an adaptation of the Supportive-Expressive psychotherapy by Luborsky for cancer patients) or treatment as usual (TAU) and completed data assessment pre- and post-treatment. Fatigue was assessed with the Multidimensional Fatigue Inventory (MFI-20). All analyses were conducted as complete case analyses including 52 STPP and 54 TAU completers (n = 106). The trial is registered at http://www.controlled-trials.com, number ISRCTN96793588. Fatigue declined significantly from a high level pre-treatment to post-treatment, but remained significantly higher than among population-based controls and a mixed sample of cancer patients. Significant time by group interactions favoured STPP for the subscales reduced activity and physical fatigue and the total scale. The strength of the associations between total fatigue and depression increased from 0.49 pre-treatment to 0.63 (Quality of life −0.52 to −0.63) at follow-up. STPP is beneficial for reducing dimensions of fatigue (particularly reduced activity and physical fatigue) in depressed breast cancer patients. Chronic fatigue needs more clinical attention in this vulnerable group.

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Acknowledgments

We are grateful to the staff in the cooperating clinics for their support in patient recruitment, the participating therapists and supervisors for conducting the treatments, our student research assistants for their important support in our study and last but not least to all our participating patients without whom this study would not be possible. The study was funded by the German Cancer Aid (program ‘Psychosocial Oncology’ 01.10.2007–31.12.2012) with the reference numbers 107457/109379 (Mainz) and 107870/109381 (Leipzig).

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Authors and Affiliations

  1. Department of Mental Health, Medical Psychology & Medical Sociology, Psychosocial Oncology, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany

    Gregor Weißflog, Elmar Brähler, Katja Leuteritz, Yvette Barthel & Susanne Kuhnt

  2. Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany

    Elmar Brähler, Jörg Wiltink, Rüdiger Zwerenz & Manfred E. Beutel

Authors
  1. Gregor Weißflog
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  2. Elmar Brähler
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  3. Katja Leuteritz
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  4. Yvette Barthel
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  5. Susanne Kuhnt
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  6. Jörg Wiltink
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  7. Rüdiger Zwerenz
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  8. Manfred E. Beutel
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Correspondence to Gregor Weißflog.

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All experiments included in the trial comply with the current laws of Germany.

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Weißflog, G., Brähler, E., Leuteritz, K. et al. Does psychodynamic short-term psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial. Breast Cancer Res Treat 152, 581–588 (2015). https://doi.org/10.1007/s10549-015-3494-0

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  • DOI: https://doi.org/10.1007/s10549-015-3494-0

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