Internet-based guided self-help for glioma patients with depressive symptoms: a randomized controlled trial

• DOI: 10.1007/s11060-017-2712-5
• Publication Date: 2017-12-13T08:30:46Z
• Authors: Florien W. Boele; Martin Klein; Irma M. Verdonck-...; Pim Cuijpers; Jan J. Heimans; Tom J. Snijders; Maaike Vos; Ingeborg Bosma; Cees C. Tijssen; Jaap C. Reijneveld
• Keywords: Male; DISORDERS; CANCER-PATIENTS; VALIDATION; Young Adult; 03 medical and health sciences; DISTRESS; 0302 clinical medicine; SDG 3 - Good Health and Well-being; QUALITY-OF-LIFE; Neuro-oncology; Journal Article; Online therapy; ANXIETY; Humans; METAANALYSIS; Fatigue; Problem Solving; Internet; Cognitive Behavioral Therapy; Brain Neoplasms; Depression; Glioma; Middle Aged; 3. Good health; CEREBRAL GLIOMA; Treatment Outcome; PRIMARY BRAIN-TUMORS; Clinical Study; Quality of Life; Female; HEALTH

AbstractDepressive symptoms are common in glioma patients, and can negatively affect health-related quality of life (HRQOL). We performed a nation-wide randomized controlled trial to evaluate the effects of an online guided self-help intervention for depressive symptoms in adult glioma patients. Glioma patients with depressive symptoms were randomized to a 5-week online course based on problem-solving therapy, or a waiting list control group. After having received the intervention, the glioma patient groups combined were compared with patients with cancer outside the central nervous system (non-CNS cancer controls), who also received the intervention. Sample size calculations yielded 63 participants to be recruited per arm. The primary outcome [depressive symptoms (CES-D)] and secondary outcomes [fatigue (Checklist Individual Strength (CIS)) and HRQOL (Short Form-36)], were assessed online at baseline, post-intervention, and 3 and 12 months follow-up. In total, 89 glioma patients (intervention N = 45; waiting list N = 44) and 26 non-CNS cancer controls were included, of whom 35 and 54% completed the intervention, respectively. Recruitment could not be extended beyond 3.5 years due to funding. On depression, no statistically significant differences between the groups were found. Fatigue decreased post-treatment in the glioma intervention group compared with the waiting list group (p = 0.054, d = 0.306). At 12 months, the physical component summary (HRQOL) remained stable in glioma patients, while scores improved in non-CNS cancer controls (p = 0.035, d = 0.883). In this underpowered study, no evidence for the effectiveness of online guided self-help for depression or HRQOL in glioma patients was found, but it may improve fatigue.Trial registration Netherlands Trial Register NTR3223.