Weißflog, G., Brahler, E., Leuteritz, K., Barthel, Y., Kuhnt, S., Wiltink, J., . . . Beutel, M.E. (2015). Does psychodynamic short-term psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial. Breast Cancer Research and Treatment, 152, 581–588. 

To describe the course of fatigue in depressed patients with breast cancer and determine the effect of psychodynamic therapy on fatigue

Patients were randomly assigned to the intervention or usual care group. Usual care patients were given written information about local counseling resources and given diagnostic information to provide to physicians who could initiate antidepressants or refer them to a psychotherapist. The experimental group was given dynamic short-term psychotherapy adapted to individual needs.

• N = 106
• MEAN AGE = 52.8 years (SD = 8.8)
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: All had breast cancer and were diagnosed with depression by structured clinical interview.
• OTHER KEY SAMPLE CHARACTERISTICS: Slighty over half of the participants were married, and over one-third were separated, divorced, or widowed.

• SITE: Single site  
• SETTING TYPE: Outpatient  
• LOCATION: Germany

• PHASE OF CARE: Late effects and survivorship

• Randomized, controlled trial

• Multidimensional Fatigue Inventory (MFI)
• European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) questionnaire
• Hospital Anxiety and Depression Scale (HADS)

Overall MFI, physical fatigue, and reduced activity scores declined over time more in the psychotherapy group (p < 0.02). Depression, fatigue, and quality of life scores were significantly correlated (p < 0.01).

A short psychotherapeutic intervention to reduce fatigue in women with breast cancer was associated with a significant reduction in fatigue over time.

• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Unintended interventions or applicable interventions not described that would influence results
• No information of whether control group patients received any interventions for depression was provided.

The results of this study showed that a psychotherapy intervention to reduce depression also had a positive impact on fatigue, and that fatigue, depression, and quality of life were correlated. These findings point to the importance of identifying and managing depression in patients with cancer not only to reduce depression but to have positive effects on symptoms of fatigue and quality of life.