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Efficacy of dignity therapy for depression and anxiety in terminally ill patients: Early results of a randomized controlled trial

Published online by Cambridge University Press:  19 March 2013

Miguel Julião*
Affiliation:
Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal Center for Evidence Based Medicine, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal Department of Palliative Medicine, Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus, Casa de Saúde da Idanha, Belas, Portugal
António Barbosa
Affiliation:
Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal Department of Psychiatry, Hospital de Santa Maria, Lisbon, Portugal
Fátima Oliveira
Affiliation:
Department of Palliative Medicine, Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus, Casa de Saúde da Idanha, Belas, Portugal
Baltazar Nunes
Affiliation:
Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
António Vaz Carneiro
Affiliation:
Center for Evidence Based Medicine, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal
*
Address correspondence to: Miguel Julião, Center of Bioethics, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal. E-mail: migueljuliao@gmail.com

Abstract

Objective:

Dignity therapy (DT) is a short-term psychotherapy developed for patients living with a life-limiting illness. Our aim was to determine the influence of DT on symptoms of depression and anxiety in people with a life-threatening disease with high level of distress, referred to an inpatient palliative care unit.

Method:

This was an open-label randomized controlled trial. Sixty terminally ill patients were randomly assigned to one of two groups: intervention group (DT+ standard palliative care [SPC]) or control group (SPC alone). The main outcomes were symptoms of depression and anxiety, measured with the Hospital Anxiety and Depression Scale, assessed at baseline, day 4, day 15, and day 30 of follow-up.

Results:

Of the 60 participants, 29 were randomized to DT and 31 to SPC. Baseline characteristics were similar between the two groups. DT was associated with a significant decrease in depressive symptoms at day 4 and day 15 (mean = −4.46, 95% CI, −6.91–2.02, p = 0.001; mean= −3.96, 95% CI, −7.33 to −0.61; p = 0.022, respectively), but not at day 30 (mean = −3.33, 95% CI, −7.32–0.65, p = 0.097). DT was also associated with a significant decrease in anxiety symptoms at each follow-up (mean= −3.96, 95% CI, −6.66 to −1.25, p = 0.005; mean= −6.19, 95% CI, −10.49 to −1.88, p = 0.006; mean = −5.07, 95% CI, −10.22 to −0.09, p = 0.054, respectively).

Significance of results:

DT appears to have a short-term beneficial effect on the depression and anxiety symptoms that often accompany patients at the end of their lives. Future research with larger samples compared with other treatments is needed to better understand the potential benefits of this psychotherapy.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

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