The treatment of depression in patients with advanced cancer undergoing palliative care

Depression is a common condition affecting those with advanced cancer, but evidence for effective treatment has been sparse. In recent years, there has been a welcome increase in research activity, with both pharmacological and nonpharmacological treatments being trialled.

This review assesses recent studies of pharmacological interventions including antidepressants and psychostimulants and nonpharmacological interventions including cognitive behavioural therapy, supportive expressive group therapy, couples therapy, complex interventions and aromatherapy massage for treatment of depression. Recent published systematic reviews of interventions for depression are also discussed.

Recent research efforts have paid particular attention to psychological interventions, with cognitive behavioural therapy approaches being most evaluated and showing some encouraging results. Pharmacological interventions remain challenging to assess using rigorous clinical trial methodology, and clinicians still rely upon data derived from studies using general populations and those with less advanced disease or other physical illness. Methodologically sound trials of pharmacological interventions for treatment of depression in advanced disease remains an area of research need.