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Efficacious Web-Based Psychotherapy to Address Depression and Anxiety Among Patients Receiving Oncological and Palliative Care: an Open-Label Randomised Controlled Trial

Published online by Cambridge University Press:  19 July 2023

N. Alavi*
Affiliation:
Psychiatry, Queen’s University, Kingston, Canada
M. Omrani
Affiliation:
Psychiatry, OPTT inc, New York, United States
A. Shirazi
Affiliation:
OPTT inc, Toronto
G. Layzell
Affiliation:
Psychiatry, Queen’s University, Kingston, Canada
J. Eadie
Affiliation:
Psychiatry, Queen’s University, Kingston, Canada
J. Jagayat
Affiliation:
neuroscience
C. Stephenson
Affiliation:
Psychiatry, Queen’s University, Kingston, Canada
D. Kain
Affiliation:
Queen’s University, Kingston, Canada
C. Soares
Affiliation:
Psychiatry, Queen’s University, Kingston, Canada
M. Yang
Affiliation:
Psychiatry, Queen’s University, Kingston, Canada
*
*Corresponding author.

Abstract

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Introduction

Oncological and palliative care patients face unique stressors which increase their risk of developing depression and anxiety. Cognitive behavioural therapy (CBT) and mindfulness has established success in improving this population’s mental health. Traditional face-to-face psychotherapy is costly, has long wait lists, often lacks accessibility, and has strict scheduling, each of which can make attending psychotherapy physically, mentally, and financially out of reach for oncological and palliative patients. Web-based CBT (e-CBT) is a promising alternative that has shown efficacy in this and other patient populations.

Objectives

To quantify the efficacy of online CBT and mindfulness therapy in oncological and palliative patients experiencing depression and anxiety symptoms.

Methods

Participants with depression or anxiety related to their diagnosis were recruited from care settings in Kingston, Ontario, and randomly assigned to 8 weekly e-CBT/mindfulness modules (N= 25) or treatment as usual (TAU; N=24). Modules consisted of CBT concepts, problem-solving, mindfulness, homework, and personalised feedback from their therapist through a secure platform (Online Psychotherapy Tool- OPTT) Participants completed PHQ-9 and GAD-7 in weeks 1, 4, and 8. (NCT04664270: REB# 6031471).

Results

Significant decreases in PHQ-9 and GAD-7 scores within individuals support the hypothesis of efficacy. At this time, 10 e-CBT/mindfulness and 12 TAU have completed the study. Decreases in PHQ-9 and GAD-7 scores within e-CBT group support the hypothesis of efficacy. Specifically, PHQ-9 scores decreased over the 3 repeated measures (ANOVA, 2 groups, 3 repeated measures and the decrease in GAD-7 scores was similarly large)

Conclusions

As hypothesized, the results suggest that e-CBT/mindfulness therapy is an affordable, accessible, and efficacious mental health treatment for this population. The virtual, asynchronous delivery format is particularly appropriate given the unique barriers.

Disclosure of Interest

N. Alavi Shareolder of: OPTT inc, Grant / Research support from: department psychiatry Queen’s University, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, G. Layzell: None Declared, J. Eadie: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, D. Kain: None Declared, C. Soares: None Declared, M. Yang: None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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