A new Dartmouth-led study finds that patients with depression and advanced cancer live longer when exposed to palliative-care interventions designed to improve quality of life.
Published in Health Psychology, the findings provide new insight into the relationship between depression and survival, says co-lead author Jay Hull, a professor of psychological and brain sciences and associate dean of faculty for the social sciences.
The study draws on data from two trials with advanced cancer patients using ENABLE (Educate, Nurture, Advise, Before Life Ends), a palliative-care intervention designed to improve the quality of life among patients diagnosed with cancer. The researchers compared the effect that early intervention, delayed intervention or no palliative-care intervention had on the survival rates as a function of the patient’s initial level of depression.
In general, higher levels of depression at the beginning of the study were associated with shorter survival periods. This was especially true for those with higher levels of depression who did not receive the palliative-care intervention. In contrast, the survival rate for those with higher levels of depression who experienced the palliative-care intervention improved significantly, says Hull.
“Although the effect of the palliative-care intervention on survival is clear, the mechanism behind it is not. One possibility is that those who are depressed are less attentive to their health, illustrating how traditional care may be insufficient to help patients overcome this deficit. Yet a tailored intervention may succeed by motivating health-promoting behaviors, which may enable patients to live longer,” he says.
The researchers conclude, “This study is the first to demonstrate that patients with advanced cancer who also have depressive symptoms benefit the most from early palliative care. Future research should be devoted to exploring the mechanisms responsible for these relationships.”
Other contributors to the study include co-lead author Anna Prescott, a senior evaluation and research analyst at the Vermont Student Assistance Corp., who was a Dartmouth graduate student in psychological and brain sciences at the time of the study; and senior author Marie Bakitas, associate director of the Center for Palliative and Supportive Care at the University of Alabama at Birmingham, who co-led the ENABLE studies while at Dartmouth.
Amy Olson can be reached at Amy.D.Olson@dartmouth.edu.