No votes yet


Putting Evidence Into Practice: Evidence-Based Interventions for Depression

Caryl D. Fulcher
Hee-Ju Kim
Patsy R. Smith
Tammie L. Sherner
CJON 2014, 18(6), 26-37 DOI: 10.1188/14.CJON.S3.26-37

Depression is a distressing emotion that occurs during various times of the cancer trajectory. Depression often goes unrecognized and untreated, which can significantly affect cost, quality of life, and treatment adherence. The Oncology Nursing Society's Putting Evidence Into Practice depression project team reviewed current literature to identify evidence-based interventions to reduce depression in people with cancer. Pharmacologic and nonpharmacologic interventions were evaluated, and opportunities for nurses to integrate recommendations into practice are offered in this article.


Akechi, T., Ietsugu, T., Sukigara, M., Okamura, H., Nakano, T., Akizuki, N., … Uchitomi, Y. (2009). Symptom indicator of severity of depression in cancer patients: A comparison of the DMS-IV criteria with alternative diagnostic criteria. <i>General Hospital Psychiatry, 31</i>, 225-232.

Akechi, T., Okuyama, T., Onishi, J., Morita, T., & Furukawa, T. A. (2008). Psychotherapy for depression among incurable cancer patients. <i>Cochrane Database of Systematic Reviews, 2</i>, CD005537. doi:10.1002/14651858.CD005537.pub2

American Psychiatric Association. (2013). <i>Diagnostic and statistical manual of mental disorders</i> (5th ed.). Arlington, VA: Author.

Amodeo, L., Castelli, L., Leombruni, P., Cipriani, D., Biancofiore, A., & Torta, R. (2011). Slow versus standard up-titration of paroxetine for the treatment of depression in cancer patients: A pilot study. <i>Supportive Care in Cancer, 20</i>, 375-384.

Ando, M., Morita, T., Akechi, T., Ito, S., Tanaka, M., Ifuku, Y., & Nakayama, T. (2009). The efficacy of mindfulness-based meditation therapy on anxiety, depression, and spirituality in Japanese patients with cancer. <i>Journal of Palliative Medicine, 12</i>, 1091-1094. doi:10.1089/jpm.2009.0143

Ashing, K., & Rosales, M. (2013). A telephonic-based trial to reduce depressive symptoms among Latina breast cancer survivors. <i>Psycho-Oncology, 23</i>, 507-515. doi:10.1002/pon.3441

Australian Government National Health and Medical Research Council. (2003). Clinical practice guidelines for the psychosocial care of adults with cancer. Retrieved from <a target="_blank" href='http://www.nhmrc.gov.au/publications/synopses/cp90syn.htm'>http://www.nh...

Badger, T. A., Segrin, C., Figueredo, A. J., Harrington, J., Sheppard, K., Passalacqua, S., … Bishop, M. (2011). Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners. <i>Quality of Life Research, 20</i>, 833-844. doi:10.1007/s11136-010-9822-2

Bar-Sela, G., Atid, L., Danos, S., Gabay, N., & Epelbaum, R. (2007). Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. <i>Psycho-Oncology, 6</i>, 980-984.

Berglund, G., Petersson, L. M., Eriksson, K. C., Wallenius, I., Roshanai, A. Nordin, K. M., … Häggman, M. (2007). "Between Men": A psychosocial rehabilitation programme for men with prostate cancer. <i>Acta Oncologica, 46</i>, 83-89. doi:10.1080/02841860600857326

Beutel, M. E., Weißflog, G., Leuteritz, K., Wiltink, J., Haselbacher, A., Ruckes, C., … Brahler, E. (2014). Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: Results of a randomized controlled multicenter trial. <i>Annals of Oncology, 25</i>, 378-384. doi:10.1093/annonc/mdt526

Björneklett, H. G., Rosenblad, A., Lindemalm, C., Ojutkangas, M. L., Letocha, H., Strang, P., & Bergkvist, L. (2013). Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer. <i>Journal of Psychosomatic Research, 74</i>, 346-353. doi:10.1016/j.jpsychores.2012.11.005

Boesen, E. H., Karlsen, R., Christensen, J., Paaschburg, B., Nielsen, D., Bloch, I. S., … Johansen, C. (2011). Psychosocial group intervention for patients with primary breast cancer: A randomised trial. <i>European Journal of Cancer, 47</i>, 1363-1372. doi:10.1016/j.ejca.2011.01.002.

Bower, J. E., Garet, D., Sternlieb, B., Ganz, P. A., Irwin, M. R., Olmstead, R., & Greendale, G. (2012). Yoga for persistent fatigue in breast cancer survivors: A randomized controlled trial. <i>Cancer, 118</i>, 3766-3775. doi:10.1002/cncr.26702

Bradt, J., Dileo, C., Grocke, D., & Magill, L. (2011). Music interventions for improving psychological and physical outcomes in cancer patients. <i>Cochrane Database of Systematic Reviews, 8</i>, CD006911. doi:10.1002/14651858.CD006911.pub2

Brothers, B. M., Yang, H. C., Strunk, D. R., & Andersen, B. L. (2011). Cancer patients with major depressive disorder: Testing a biobehavioral/cognitive behavior intervention. <i>Journal of Consulting and Clinical Psychology, 79</i>, 253-260. doi:10.1037/a0022566

Brown, J. C., Huedo-Medina, T. B., Pescatello, L. S., Ryan, S. M., Pescatello, S. M., Moker, E., … Johnson, B. T. (2012). The efficacy of exercise in reducing depressive symptoms among cancer survivors: A meta-analysis. <i>PLOS One, 7</i>, e30955.

Bruera, E., Yennurajalingam, S., Palmer, J. L., Perez-Cruz, P. E., Frisbee-Hume, S., Allo, J. A., … Cohen, M. Z. (2013). Methylphenidate and/or a nursing telephone intervention for fatigue in patients with advanced cancer: A randomized, placebo-controlled, phase II trial. <i>Journal of Clinical Oncology, 31</i>, 2421-2427. doi:10.1200/JCO.2012.45.3696

Buffart, L. M., van Uffelen, J. G., Riphagen, I. I., Brug, J., van Mechelen, W., Brown, W. J., & Chinapaw, M. J. (2012). Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. <i>BMC Cancer, 12</i>, 559. doi:10.1186/1471-2407-12-559

Cankurtaran, E. S., Ozalp, E., Soygur, H., Akbiyik, D. I., Turhan, L., & Alkis, N. (2008). Mirtazapine improves sleep and lowers anxiety and depression in cancer patients: Superiority over imipramine. <i>Supportive Care in Cancer, 16</i>, 1291-1298. doi:10.1007/s00520-008-0425-1

Cantarero-Villanueva, I., Fernández-Lao, C., Cuesta-Vargas, A., Del Moral-Avila, R., Fernández-de-las-Peñas, C., & Arroyo-Morales, M. (2013). The effectiveness of a deep water aquatic exercise program in cancer-related fatigue in breast cancer survivors: A randomized controlled trial. <i>Archives of Physical Medicine and Rehabilitation, 94</i>, 221-230. doi:10.1016/j.apmr.2012.09.008

Carayol, M., Bernard, P., Boiche, J., Riou, F., Mercier, B., Cousson-Gelie, F., … Ninot, G. (2013). Psychological effect of exercise in women with breast cancer receiving adjuvant therapy: What is the optimal dose needed? <i>Annals of Oncology, 24</i>, 291-300. doi:10.1093/annonc/mds342

Chan, R. J., Webster, J., & Marquart, L. (2011). Information interventions for orienting patients and their carers to cancer care facilities. <i>Cochrane Database of Systematic Reviews, 12</i>, CD008273. doi:10.1002/14651858.CD008273.pub2

Chen, Z., Meng, Z., Milbury, K., Bei, W., Zhang, Y., Thornton, B., … Cohen, L. (2012). Qigong improves quality of life in women undergoing radiotherapy for breast cancer: Results of a randomized controlled trial. <i>Cancer, 119</i>, 1690-1698. doi:10.1002/cncr.27904

Chien, C. H., Liu, K. L., Chien, H. T., & Liu, H. E. (2014). The effects of psychosocial strategies on anxiety and depression of patients diagnosed with prostate cancer: A systematic review. <i>International Journal of Nursing Studies, 51</i>, 28-38. doi:10.1016/j.ijnurstu.2012.12.019

Chipperfield, K., Brooker, J., Fletcher, J., & Burney, S. (2013). The impact of physical activity on psychosocial outcomes in men receiving androgen deprivation therapy for prostate cancer: A systematic review. <i>Health Psychology.</i> Advanced online publication. doi:10.1037/hea0000006

Craft, L. L., Vaniterson, E. H., Helenowski, I. F., Rademaker, A. W., & Courney, K. S. (2012). Exercise effects on depressive symptoms in cancer survivors: A systematic review and meta-analysis. <i>Cancer Epidemiology, Biomarkers and Prevention, 21</i>, 3-19. doi:10.1158/1055-9965.EPI-11-0634

Cramer, H., Lange, S., Klose, P., Paul, A., & Dobos, G. (2012). Yoga for breast cancer patients and survivors: A systematic review and meta-analysis. <i>BMC Cancer, 12</i>, 412. doi:10.1186/1471-2407-12-412

da Costa Miranda, M. V., Trufelli, D. C., Santos, J., Campos, M. P., Nobuo, M., da Costa Miranda, M., … del Giglio, A. (2009). Effectiveness of guaraná (Paullinia cupana) for post radiation fatigue and depression: Results of a pilot double-blind randomized study. <i>Journal of Alternative and Complementary Medicine, 15</i>, 431-433. doi:10.1089/acm.2008.0324

Deng, G., Chan, Y., Sjoberg, D., Vickers, A., Yeung, K. S., Kris, M., … Cassileth, B. (2013). Acupuncture for the treatment of post-chemotherapy chronic fatigue: A randomized, blinded, sham-controlled trial. <i>Supportive Care in Cancer, 21</i>, 1735-1741. doi:10.1007/s00520-013-1720-z

Dhruva, A., Miaskowski, C., Abrams, D., Acree, M., Cooper, B., Goodman, S., & Hecht, F. M. (2012). Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: Results of a pilot randomized controlled trial. <i>Journal of Alternative and Complementary Medicine, 18</i>, 473-479.

DiMatteo, M. R., & Haskard-Zolnierek, K. B. (2011). Impact of depression on treatment adherence and survival from cancer. In D. W. Kissane, M. Maj, & N. Sartorius, (Eds.), <i>Depression and cancer</i> (pp. 101-124). Oxford, UK: John Wiley and Sons.

D'Silva, S., Poscablo, C., Habousha, R., Kogan, M., & Kligler, B. (2012). Mind-body medicine therapies for a range of depression severity: A systematic review. <i>Psychosomatics, 53</i>, 407-423. doi:10.1016/j.psym.2012.04.006

D'Souza, V., Blouin, E., Zeitouni, A., Muller, K., & Allison, P. J. (2012). An investigation of the effect of tailored information on symptoms of anxiety and depression in head and neck cancer patients. <i>Oral Oncology, 49</i>, 431-437. doi:10.1016/j.oraloncology.2012.12.001

Ell, K., Xie, B., Kapetanovic, S., Quinn, D. I., Lee, P. J., Wells, A., & Chou, C. P. (2011). One-year follow-up of collaborative depression care for low-income, predominantly Hispanic patients with cancer. <i>Psychiatric Services, 62</i>, 162-170. doi:10.1176/appi.ps.62.2.162

Ergun, M., Eyigor, S., Karaca, B., Kisim, A., & Uslu, R. (2013). Effects of exercise on angiogenesis and apoptosis-related molecules, quality of life, fatigue and depression in breast cancer patients. <i>European Journal of Cancer Care, 22</i>, 626-637. doi:10.1111/ecc.12068

Ersoy, M. A., Noyan, A. M., & Elbi, H. (2008). An open-label long-term naturalistic study of mirtazapine treatment for depression in cancer patients. <i>Clinical Drug Investigation, 28</i>, 113-120.

Feng, Y., Wang, X. Y., Li, S. D., Zhang, Y., Wang, H. M., Li, M., … Zhang, Z. (2011). Clinical research of acupuncture on malignant tumor patients for improving depression and sleep quality. <i>Journal of Traditional Chinese Medicine, 31</i>, 199-202.

Fleming, L., Randell, K., Harvey, C. J., & Espie, C. A. (2014). Does cognitive behaviour therapy for insomnia reduce clinical levels of fatigue, anxiety and depression in cancer patients? <i>Psycho-Oncology, 23</i>, 679-684. doi:10.1002/pon.3468

Frattaroli J. (2006). Experimental disclosure and its moderators: A meta-analysis. <i>Psychological Bulletin, 132</i>, 823-865. doi:10.1037/0033-2909.132.6.823

Fulcher, C. D., & Badger, T. (2009). Depression. In L. H. Eaton & J. M. Tipton (Eds.), <i>Putting Evidence Into Practice: Improving oncology patient outcomes</i> (pp. 105-118). Pittsburgh, PA: Oncology Nursing Society.

Fulcher, C. D., Badger, T., Gunter, A. K., Marrs, J. A., & Reese, J. M. (2008). Putting Evidence Into Practice: Interventions for depression. <i>Clinical Journal of Oncology Nursing, 12</i>, 131-140. doi:10.1188/08.CJON.131-140

Gagnon, B., Murphy, J., Eades, M., Lemoignan, J., Jelowicki, M., Carney, S., … Macdonald, N. (2013). A prospective evaluation of an interdisciplinary nutrition-rehabilitation program for patients with advanced cancer. <i>Current Oncology, 20</i>, 31-318. doi:10.3747/co.20.1612

Galantino, M. L., Callens, M. L., Cardena, G. J., Piela, N. L., & Mao, J. J. (2013). Tai chi for well-being of breast cancer survivors with aromatase inhibitor-associated arthralgias: A feasibility study. <i>Alternative Therapies in Health and Medicine, 19</i>, 38-44.

Galway, K., Black, A., Cantwell, M., Cardwell, C. R., Mills, M., & Donnelly, M. (2012). Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. <i>Cochrane Database of Systematic Reviews, 11</i>, CD007064. doi:10.1002/14651858.CD007064.pub2

Garcia, M. K., McQuade, J., Haddad, R., Patel, S., Lee, R., Yang, P., … Cohen, L. (2013). Systematic review of acupuncture in cancer care: A synthesis of the evidence. <i>Journal of Clinical Oncology, 31</i>, 952-960. doi:10.1200/JCO.2012.43.5818

Garland, S. N., Tamagawa, R., Todd, S. C., Speca, M., & Carlson, L. E. (2013). Increased mindfulness is related to improved stress and mood following participation in a mindfulness-based stress reduction program in individuals with cancer. <i>Integrative Cancer Therapies, 12</i>, 31-40. doi:10.1177/1534735412442370

Gehring, K., Patwardhan, S. Y., Collins, R., Groves, M. D., Etzel, C. J., Meyers, C. A., & Wefel, J. S. (2012). A randomized trial on the efficacy of methylphenidate and modafinil for improving cognitive functioning and symptoms in patients with a primary brain tumor. <i>Journal of Neuro-Oncology, 107</i>, 165-174.

Girgis, A., Breen, S., Stacey, F., & Lecathelinais, C. (2009). Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. <i>Journal of Clinical Oncology, 27</i>, 6180-6190. doi:10.1200/JCO.2009.22.8718

Given, C., Given, B., Rahbar, M., Jean, S., McCorkle, R., & Cimprich, B. (2004). Does a symptom management intervention affect depression among cancer patients: Results from a clinical trial? <i>Psycho-Oncology, 13</i>, 818-830.

Goerling, U., Foerg, A., Sander, S., Schramm, N., & Schlag, P. M. (2011). The impact of short-term psycho-oncological interventions on the psychological outcome of cancer patients of a surgical-oncology department. A randomized controlled study. <i>European Journal of Cancer, 47</i>, 2009-2014.

Gong, S., Sheng, P., Jin, H., He, H., Qi, E., Chen, W., … Hou, L. (2014). Effect of methylphenidate in patients with cancer-related fatigue: A systematic review and meta-analysis. <i>PLOS One, 9</i>, e84391. doi:10.1371/journal.pone.0084391

Gotay, C. C., Moinpour, C. M., Unger, J. M., Jiang, C. S., Coleman, D., Martino, S., … Albain, K. S. (2007). Impact of a peer-delivered telephone intervention for women experiencing a breast cancer recurrence. <i>Journal of Clinical Oncology, 25</i>, 2093-2099. doi:10.1200/JCO.2006.07.4674

Greer, J. A., Traeger, L., Bemis, H., Solis, J., Hendriksen, E. S., Park, E. R., … Safren, S. A. (2012). A pilot randomized controlled trial of brief cognitive-behavioral therapy for anxiety in patients with terminal cancer. <i>Oncologist, 17</i>, 1337-1345. doi:10.1634/theoncologist.2012-0041

Griffiths, K. M., Calear, A. L., & Banfield, M. (2009). Systematic review on internet support groups (ISGs) and depression (1): Do ISGs reduce depressive symptoms? <i>Journal of Medical Internet Research, 11</i>, e40. doi:10.2196/jmir.1270

Groarke, A., Curtis, R., & Kerin, M. (2013). Cognitive-behavioural stress management enhances adjustment in women with breast cancer. <i>British Journal of Health Psychology, 18</i>, 623-641. doi:10.1111/bjhp.12009

Guo, Z., Tang, H. Y., Li, H., Tan, S. K., Feng, K. H., Huang, Y. C., … Jiang, W. (2013). The benefits of psychosocial interventions for cancer patients undergoing radiotherapy. <i>Health and Quality of Life Outcomes, 11</i>, 121. doi:10.1186/1477-7525-11-121

Hanna, L. R., Avila, P. F., Meteer, J. D., Nicholas, D. R., & Kaminsky, L. A. (2008). The effects of a comprehensive exercise program on physical function, fatigue, and mood in patients with various types of cancer. <i>Oncology Nursing Forum, 35</i>, 461-469. doi:10.1188/08.ONF.461-469

Hanssens, S., Luyten, R., Watthy, C., Fontaine, C., Decoster, L., Baillon, C., … De Grève, J. (2011). Evaluation of a comprehensive rehabilitation program for post-treatment patients with cancer [Online exclusive]. <i>Oncology Nursing Forum, 38</i>, E418-E424. doi:10.1188/11.ONF.E418-E424

Harder, H., Parlour, L., & Jenkins, V. (2012). Randomised controlled trials of yoga interventions for women with breast cancer: A systematic literature review. <i>Supportive Care in Cancer, 20</i>, 3055-3064. doi:10.1007/s00520-012-1611-8

Hart, S. L., Hoyt, M. A., Diefenbach, M., Anderson, D. R., Kilbourn, K. M., Craft, L. L., … Stanton, A. L. (2012). Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. <i>Journal of the National Cancer Institute, 104</i>, 990-1004. doi:10.1093/jnci/djs256

Herschbach, P., Berg, P., Waadt, S., Duran, G., Engst-Hastreiter, U., Henrich, G., … Dinkel, A. (2010). Group psychotherapy of dysfunctional fear of progression in patients with chronic arthritis or cancer. <i>Psychotherapy and Psychosomatics, 79</i>, 31-38. doi:10.1159/000254903

Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. <i>Journal of Consulting and Clinical Psychology, 78</i>, 169-183. doi:10.1037/a0018555

Hopko, D. R., Armento, M. E., Robertson, S. M., Ryba, M. M., Carvalho, J. P., Colman, L. K., … Lejuez, C. W. (2011). Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: Randomized trial. <i>Journal of Consulting and Clinical Psychology, 79</i>, 834-849. doi:10.1037/a0025450

Husson, O., Mols, F., & van de Poll-Franse, L. V. (2011), The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: A systematic review. <i>Annals of Oncology, 22</i>, 761-772. doi:10.1093/annonc/mdq413

Jacobsen, P. B., Phillips, K. M., Jim, H. S., Small, B. J., Faul, L. A., Meade, C. D., … Wilson, R. W. (2013). Effects of self-directed stress management training and home-based exercise on quality of life in cancer patients receiving chemotherapy: A randomized controlled trial. <i>Psycho-Oncology, 22</i>, 1229-1235. doi:10.1002/pon.3122

Jensen-Johansen, M. B., Christensen, S., Valdimarsdottir, H., Zakowski, S., Jensen, A. B., Bovbjerg, D. H., & Zachariae, R. (2012). Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors—Results from a nationwide randomized clinical trial. <i>Psycho-Oncology, 22</i>, 1492-1500. doi:10.1002/pon.3193

Kangas, M., Milross, C., Taylor, A., & Bryant, R. A. (2012). A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients. <i>Psycho-Oncology, 22</i>, 1665-1673. doi:10.1002/pon.3208

Kao, C. Y., Hu, W. Y., Chiu, T. Y., & Chen, C. Y. (2014). Effects of the hospital-based palliative care team on the care for cancer patients: An evaluation study. <i>International Journal of Nursing Studies, 51</i>, 226-235.

Khan, F., Amatya, B., Pallant, J. F., Rajapaksa, I., & Brand, C. (2012). Multidisciplinary rehabilitation in women following breast cancer treatment: A randomized controlled trial. <i>Journal of Rehabilitation Medicine, 44</i>, 788-794. doi:10.2340/16501977-1020

Kim, H. J., Barsesvick, A., Beck, S. L., & Dudley, W. (2012). Clinical subgroups of a psychoneurologic symptom cluster in women receiving treatment for breast cancer: A secondary analysis [Online exclusive]. <i>Oncology Nursing Forum, 39</i>, E20-E29. doi:10.1188/12.ONF.E20-E30

Kim, Y. H., Kim, H. J., Ahn, S. D., Seo, Y. J., & Kim, S. H. (2013). Effects of meditation on anxiety, depression, fatigue, and quality of life of women undergoing radiation therapy for breast cancer. <i>Complementary Therapies in Medicine, 21</i>, 379-387. doi:10.1016/j.ctim.2013.06.005

Kleiboer, A., Bennett, F., Hodges, L., Walker, J., Thekkumpurath, P., & Sharpe, M. (2011). The problems reported by cancer patients with major depression. <i>Psycho-Oncology, 20</i>, 62-68.

Klemm, P. (2012). Effects of online support group format (moderated vs peer-led) on depressive symptoms and extent of participation in women with breast cancer. <i>Computers, Informatics, Nursing, 30</i>, 9-18. doi:10.1097/NCN.0b013e3182343efa

Kligler, B., Homel, P., Harrison, L. B., Sackett, E., Levenson, H., Kenney, J., … Merrell, W. (2011). Impact of the Urban Zen Initiative on patients' experience of admission to an inpatient oncology floor: A mixed-methods analysis. <i>Journal of Alternative and Complementary Medicine, 17</i>, 729-734. doi:10.1089/acm.2010.0533

Komatsu, H., Hayashi, N., Suzuki, K., Yagasaki, K., Iioka, Y., Neumann, J., … Ueno, N. T. (2012). Guided self-help for prevention of depression and anxiety in women with breast cancer. <i>ISRN Nursing, 2012</i>, 716367. doi:10.5402/2012/716367

Korstjens, I., Mesters, I., May, A. M., van Weert, E., van den Hout, J. H., Ros, W., … van den Borne, B. (2011). Effects of cancer rehabilitation on problem-solving, anxiety and depression: A RCT comparing physical and cognitive-behavioural training versus physical training. <i>Psychology and Health, 1</i>, 63-82. doi:10.1080/08870441003611569

Kroenke, K., Theobald, D., Wu, J., Norton, K., Morrison, G., Carpenter, J., & Tu, W. (2010). Effect of telecare management on pain and depression in patients with cancer: A randomized trial. <i>JAMA, 304</i>, 163-171. doi:10.1001/jama.2010.944

Krohn, M., Listing, M., Tjahjono, G., Reisshauer, A., Peters, E., Klapp, B. F., & Rauchfuss, M. (2011). Depression, mood, stress, and Th1/Th2 immune balance in primary breast cancer patients undergoing classical massage therapy. <i>Supportive Care in Cancer, 19</i>, 1303-1311. doi:10.1007/s00520-010-0946-2

Kwiatkowski, F., Mouret-Reynier, M. A., Duclos, M., Leger-Enreille, A., Bridon, F., Hahn, T., … Bignon, Y. J. (2013). Long term improved quality of life by a 2-week group physical and educational intervention shortly after breast cancer chemotherapy completion. Results of the ‘Programme of accompanying women after breast cancer treatment completion in thermal resorts’ (PACThe) randomised clinical trial of 251 patients. <i>European Journal of Cancer, 49</i>, 1530-1538. doi:10.1016/j.ejca.2012.12.021

Laoutidis, Z. G., & Mathiak, K. (2013). Antidepressants in the treatment of depression/depressive symptoms in cancer patients: Asystematic review and meta-analysis. <i>BMC Psychiatry, 13</i>, 140. doi:10.1186/1471-244X-13-140

Lengacher, C. A., Reich, R. R., Post-White, J., Moscoso, M., Shelton, M. M., Barta, M., … Budhrani, P. (2012). Mindfulness based stress reduction in post-treatment breast cancer patients: An examination of symptoms and symptom clusters. <i>Journal of Behavioral Medicine, 35</i>, 86-94. doi:10.1007/s10865-011-9346-4.

Li, W. H., Chung, J. O., & Ho, E. K. (2011). The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalised with cancer. <i>Journal of Clinical Nursing, 20</i>, 2135-2143. doi:10.1111/j.1365-2702.2011.03733.x

Liu, C. J., Hsiung, P. C., Chang, K. J., Liu, Y. F., Wang, K. C., Hsiao, F. H., … Chan, C. L. (2008). A study on the efficacy of body-mind-spirit group therapy for patients with breast cancer. <i>Journal of Clinical Nursing, 17</i>, 2539-2549. doi:10.1111/j.1365-2702.2008.02296.x

Lloyd-Williams, M., Cobb, M., O'Connor, C., Dunn, L., & Shiels, C. (2012). A pilot randomized controlled trial to reduce suffering and emotional distress in patients with advanced cancer. <i>Journal of Affective Disorders, 148</i>, 141-145. doi:10.1016/j.jad.2012.11.013

Low, C. A., Stanton, A. L., Bower, J. E., & Gyllenhammer, L. (2010). A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer. <i>Health Psychology, 29</i>, 460-466. doi:10.1037/a0020153

Luebbert, K., Dahme, B., & Hasenbring, M. (2001). The effectiveness of relaxation training in reducing treatment-related symptoms and improving emotional adjustment in acute non-surgical cancer treatment: A meta-analytical review. <i>Psycho-Oncology, 10</i>, 490-502. doi:10.1002/pon.537

Lutgendorf, S. K., Mullen-Houser, E., Russell, D., Degeest, K., Jacobson, G., Hart, L., … Lubaroff, D. M. (2010). Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach. <i>Brain, Behavior, and Immunity, 24</i>, 1231-1240. doi:10.1016/j.bbi.2010.06.014

Lydiatt, W. M., Bessette, D., Schmid, K. K., Sayles, H., & Burke, W. J. (2013). Prevention of depression with escitalopram in patients undergoing treatment for head and neck cancer: Randomized, double-blind, placebo-controlled clinical trial. <i>JAMA Otolaryngology, 139</i>, 678-686. doi:10.1001/jamaoto.2013.3371

Lydiatt, W. M., Denman, D., McNeilly, D. P., Puumula, S. E., & Burke, W. J. (2008). A randomized, placebo-controlled trial of citalopram for the prevention of major depression during treatment for head and neck cancer. <i>JAMA Otolaryngology, 134</i>, 528-535.

Massie, M. J. (2004). Prevalence of depression in patients with cancer. <i>Journal of the National Cancer Institute. Monographs, 32</i>, 57-71. doi:10.1093/jncimonographs/lgh014

Massie, M. J., Lloyd-Williams, M., Irving, G., & Miller, K. (2011). The prevalence of depression in people with cancer. In D. W. Kissane, M. Maj, & N. Sartorius (Eds.), <i>Depression and cancer</i> (pp. 1-36). Oxford, UK: John Wiley and Sons.

McMillan, S. C., Small, B. J., & Haley, W. E. (2011). Improving hospice outcomes through systematic assessment. <i>Cancer Nursing, 34</i>, 89-97. doi:10.1097/NCC.0b013e3181f70aee

Mehnert, A., Veers, S., Howaldt, D., Braumann, K. M., Koch, U., & Schulz, K. H. (2011). Effects of a physical exercise rehabilitation group program on anxiety, depression, body image, and health-related quality of life among breast cancer patients. <i>Onkologie, 34</i>, 248-253. doi:10.1159/000327813

Meijer, A., Roseman, M., Milette, K., Coyne, J. C., Stefanek, M. E., Ziegelstein, R. C., … Thombs, B. D. (2011). Depression screening and patient outcomes in cancer: A systematic review. <i>PLoS One, 6</i>, e27181. doi:10.1371/journal.pone.0027181

Miaskowski, C., Cooper, B. A., Paul, S. M., Dodd, M., Lee, K., Aouizerat, B. E., … Bank, A. (2006). Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: A cluster analysis [Online exclusive]. <i>Oncology Nursing Forum, 33</i>, E79-E89. doi:10.1188/06.ONF.E79-E89

Midtgaard, J., Rørth, M., Stelter, R., Tveterås, A., Andersen, C., Quist, M., … Adamsen, L. (2005). The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: A phase II study. <i>Palliative and Supportive Care, 3</i>, 197-208.

Milbury, K., Chaoul, A., Biegler, K., Wangyal, T., Spelman, A., Meyers, C. A., … & Cohen, L. (2013). Tibetan sound meditation for cognitive dysfunction: Results of a randomized controlled pilot trial. <i>Psycho-Oncology, 22</i>, 2354-2363. doi:10.1002/pon.3296

Miller, K., & Massie, M. J. (2006). Depression and anxiety. <i>Cancer Journal, 12</i>, 388-397. doi:10.1097/00130404-200609000-00008

Miller, K., & Massie, M. J. (2010). Depressive disorders. In J. C. Holland, W. S. Breitbart, P. B. Jacobsen, M. S. Lederberg, M. J. Loscalzo, & R. McCorkle (Eds.), <i>Psycho-oncology</i> (2nd ed., pp. 311-318). New York, NY: Oxford University Press.

Mitchell, S. A., & Friese, C. R. (n.d.). ONS PEP (Putting Evidence into Practice) weight of evidence classification schema. Decision rules for summative evaluation of a body of evidence. Retrieved from <a target="_blank" href='http://www2.ons.org/Research/media/ons/docs/research/outcomes/weight-of-...

Molassiotis, A., Bardy, J., Finnegan-John, J., Mackereth, P., Ryder, D. W., Filshie, J., … Richardson, A. (2012). Acupuncture for cancer-related fatigue in patients with breast cancer: A pragmatic randomized controlled trial. <i>Journal of Clinical Oncology, 30</i>, 4470-4476. doi:10.1200/JCO.2012.41.6222

Molassiotis, A., Bardy, J., Finnegan-John, J., Mackereth, P., Ryder, W. D., Filshie, J., … Richardson, A. (2013). A randomized controlled trial of acupuncture self-needling as maintenance therapy for cancer related fatigue after therapist delivered acupuncture. <i>Annals of Oncology, 24</i>, 1645-1652. doi:10.1093/annonc/mdt034

Mosher, C. E., Duhamel, K. N., Lam, J., Dickler, M., Li, Y., Massie, M. J., & Norton, L. (2012). Randomised trial of expressive writing for distressed metastatic breast cancer patients. <i>Psychology and Health, 27</i>, 88-100. doi:10.1080/08870446.2010.551212

Naaman, S. C., Radwan, K., Fergusson, D., & Johnson, S. (2009). Status of psychological trials in breast cancer patients: A report of three meta-analyses. <i>Psychiatry, 72</i>, 50-69. doi:10.1521/psyc.2009.72.1.50

National Cancer Institute. (2013). Depression (PDQ®) health professional version. Retrieved from <a target="_blank" href='http://www.cancer.gov/cancertopics/pdq/supportivecare/depression/HealthP...

National Comprehensive Cancer Network. (2013). <i>NCCN Clinical Practice Guidelines in Oncology: Distress management</i> [v.2.2013]. Retrieved from <a target="_blank" href='http://www.nccn.org/professionals/physican_gls/pdf/distress.pdf'>http://...

Navari, R. M., Brenner, M. C., & Wilson, M. N. (2008). Treatment of depressive symptoms in patients with early stage breast cancer undergoing adjuvant therapy. <i>Breast Cancer Research and Treatment, 112</i>, 197-201. doi:10.1007/s10549-007-9841-z

Nunes, D. F., Rodriguez, A. L., da Silva Hoffmann, F., Luz, C., Braga Filho, A. P., Muller, M. C., & Bauer, M. E. (2007). Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects. <i>Journal of Psychosomatic Research, 63</i>, 647-655. doi:10.1016/j.jpsychores.2007.07.004

Osborn, R. L., Demoncada, A. C., & Feuerstein, M. (2006). Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: Meta-analyses. <i>International Journal of Psychiatry in Medicine, 36</i>, 13-34.

Park, H. Y., Lee, B. J., Kim, J. H., Bae, J. N., & Hahm, B. J. (2012). Rapid improvement of depression and quality of life with escitalopram treatment in outpatients with breast cancer: A 12-week, open-label prospective trial. <i>Progress in Neuropsychopharmacology and Biological Psychiatry, 30</i>, 318-323. doi:10.1016/j.pnpbp.2011.11.010

Payne, J. K., Held, J., Thorpe, J., & Shaw, H. (2008). Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. <i>Oncology Nursing Forum, 35</i>, 635-642. doi:10.1188/08.ONF.635-642

Piet, J., Würtzen, H., & Zachariae, R. (2012). The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: A systematic review and meta-analysis. <i>Journal of Consulting and Clinical Psychology, 80</i>, 1007-1020. doi:10.1037/a0028329

Pirl, W. F., Greer, J. A., Traeger, L., Jackson, V., Lennes, I. T., Gallagher, E. R., … Temel, J. S. (2012). Depression and survival in metastatic non-small-cell lung cancer: Effects of early palliative care. <i>Journal of Clinical Oncology, 30</i>, 1310-1315. doi:10.1200/JCO.2011.38.3166

Pitceathly, C., Maguire, P., Fletcher, I., Parle, M., Tomenson, B., & Creed, F. (2009). Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients? A randomised controlled trial. <i>Annals of Oncology, 20</i>, 928-934. doi:10.1093/annonc/mdn708

Post-White, J., Kinney, M. E., Savik, K., Gau, J. B., Wilcox, C., & Lerner, I. (2003). Therapeutic massage and healing touch improve symptoms in cancer. <i>Integrative Cancer Therapies, 2</i>, 332-344. doi:10.1177/1534735403259064

Potter, P. J. (2007). Breast biopsy and distress: Feasibility of testing a Reiki intervention. <i>Journal of Holistic Nursing, 25</i>, 238-248.

Qiu, J., Chen, W., Gao, X., Xu, Y., Tong, H., Yang, M., … Yang, M. (2013). A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression. <i>Journal of Psychosomatic Obstetrics and Gynaecology, 34</i>, 60-67. doi:10.3109/0167482X.2013.766791

Quintard, B., & Lakdja, F. (2008). Assessing the effect of beauty treatments on psychological distress, body image, and coping: A longitudinal study of patients undergoing surgical procedures for breast cancer. <i>Psycho-Oncology, 17</i>, 1032-1038. doi:10.1002/pon.1321

Raison, C. L., Rutherford, R. E., Woolwine, B. J., Shuo, C., Schettler, P., Drake, D. F., … Miller, A. H. (2013). A randomized controlled trial of the tumor necrosis factor antagonist infliximab for treatment-resistant depression. <i>JAMA Psychiatry, 70</i>, 31-41. doi:10.1001/2013.jamapsychiatry.4

Rajasekaran, M., Edmonds, P. M., & Higginson, I. L. (2005). Systematic review of hypnotherapy for treating symptoms in terminally ill adult cancer patients. <i>Palliative Medicine, 19</i>, 418-426. doi:10.1191/0269216305pm1030oa

Ram, S., Narayanasamy, R., & Barua, A. (2013). Effectiveness of group psycho-education on well-being and depression among breast cancer survivors of Melaka, Malaysia. <i>Indian Journal of Palliative Care, 19</i>, 34-39. doi:10.4103/0973-1075.110234

Ramachandra, P., Booth, S., Pieters, T., Vrotsou, K., & Huppert, F. A. (2009). A brief self-administered psychological intervention to improve well-being in patients with cancer: Results from a feasibility study. <i>Psycho-Oncology, 18</i>, 1323-1326. doi:10.1002%2Fpon.1516

Rayner, L., Price, A., Evans, A., Valsraj, K., Higginson, I. J., & Hotopf, M. (2010). Antidepressants for depression in physically ill people. <i>Cochrane Database of Systematic Reviews, 17</i>, CD007503. doi:10.1002/14651858.CD007503.pub2

Rodriguez-Vega, B., Palao, A., Torres G., Hospital, A., Benito, G., Pérez, E., … Bayón, C. (2011). Combined therapy versus usual care for the treatment of depression in oncologic patients: A randomized controlled trial. <i>Psycho-Oncology, 20</i>, 943-952. doi:10.1002/pon.1800

Rottmann, N., Dalton, S. O., Bidstrup, P. E., Würtzen, H., Høybye, M. T., Ross, L., … Johansen, C. (2012). No improvement in distress and quality of life following psychosocial cancer rehabilitation. A randomised trial. <i>Psycho-Oncology, 21</i>, 505-514. doi:10.1002/pon.1924

Saarto, T., Penttinen, H. M., Sievänen, H., Kellokumpu-Lehtinen, P. L., Hakamies-Blomqvist, L., Nikander, R., … Luoma, M. L. (2012). Effectiveness of a 12-month exercise program on physical performance and quality of life of breast cancer survivors. <i>Anticancer Research, 32</i>, 3875-3884.

Satin, J. R., Linden, W., & Phillips, M. J. (2009). Depression as a predictor of disease progression and mortality in cancer patients: A meta-analysis. <i>Cancer, 115</i>, 5349-5361. doi:10.1002/cncr.24561

Serfaty, M., Wilkinson, S., Freeman, C., Mannix, K., & King, M. (2012). The ToT study: Helping with Touch or Talk (ToT): A pilot randomised controlled trial to examine the clinical effectiveness of aromatherapy massage versus cognitive behaviour therapy for emotional distress in patients in cancer/palliative care. <i>Psycho-Oncology, 21</i>, 563-569. doi:10.1002/pon.1921

Sharma, M., Haider, T., & Knowlden, A. P. (2013). Yoga as an alternative and complementary treatment for cancer: A systematic review. <i>Journal of Alternative and Complementary Medicine, 19</i>, 870-875. doi:10.1089/acm.2012.0632

Sharp, D. M., Walker, M. B., Chaturvedi, A., Upadhyay, S., Hamid, A., Walker, A. A., … Walker, L. G. (2010). A randomized, controlled trial of the psychological effects of reflexology in early breast cancer. <i>European Journal of Cancer, 46</i>, 312-322. doi:10.1016/j.ejca.2009.10.006

Sharplin, G. R., Jones, S. B., Hancock, B., Knott, V. E., Bowden, J. A., & Whitford, H. S. (2010). Mindfulness-based cognitive therapy: An efficacious community-based group intervention for depression and anxiety in a sample of cancer patients. <i>Medical Journal of Australia, 193</i>, S79-S82.

Steginga, S. K., Pinnock, C., Gardner, M., Gardiner, R. A., & Dunn, J. (2005). Evaluating peer support for prostate cancer: The prostate cancer peer support inventory. <i>British Journal of Urology, 95</i>, 46-50. doi:10.1111/j.1464-410X.2005.05247.x

Strong, V., Waters, R., Hibberd, C., Murray, G., Wall, L., Walker, J., … Sharpe, M. (2008). Management of depression for people with cancer (SMaRT oncology 1): A randomised trial. <i>Lancet, 372</i>, 40-48. doi:10.1016/S0140-6736(08)60991-5

Suzuki, N., Ninomiya, M., Maruta, T., Hosonuma, S., Yoshioka, N., Ohara, T., … Ishizuka, B. (2011). Clinical study on the efficacy of fluvoxamine for psychological distress in gynecologic cancer patients. <i>International Journal of Gynecological Cancer, 21</i>, 1143-1149. doi:10.1097/IGC.0b013e3181ffbeb9

Thyme, K. E., Sundin, E. C., Wiberg, B., Oster, I., Aström, S., & Lindh, J. (2009). Individual brief art therapy can be helpful for women with breast cancer: A randomized controlled clinical study. <i>Palliative and Supportive Care, 7</i>, 87-95. doi:10.1017/S147895150900011X

Torta, R., Leombruni, P., Borio, R., & Castelli, L. (2011). Duloxetine for the treatment of mood disorder in cancer patients: A 12-week case-control clinical trial. <i>Human Psychopharmacology, 26</i>, 291-299. doi:10.1002/hup.1202

Torta, R., Siri, I., & Caldera, P. (2008). Sertraline effectiveness and safety in depressed oncological patients. <i>Supportive Care in Cancer, 16</i>, 83-91. doi:10.1007/s00520-007-0269-0

Van der Meulen, I. C., May, A. M., Ros, W. J., Oosterom, M., Hordijk, G. J., Koole, R., & de Leeuw, J. R. (2013). One-year effect of a nurse-led psychosocial intervention on depressive symptoms in patients with head and neck cancer: A randomized controlled trial. <i>Oncologist, 18</i>, 336-344. doi:10.1634/theoncologist.2012-0299

Vos, P. J., Visser, A. P., Garssen, B., Duivenvoorden, H. J., & de Haes, H. (2007). Effectiveness of group psychotherapy compared to social support groups in patients with primary, non-metastatic breast cancer. <i>Journal of Psychosocial Oncology, 25</i>, 37-60. doi:10.1300/J077v25n04_03

Walker, J., Sawhney, A., Hansen, C. H., Ahmed, S., Martin, P., Symeonides, S., … Sharpe, M. (2013). Treatment of depression in adults with cancer: A systematic review of randomized controlled trials. <i>Psychological Medicine, 44</i>, 897-907. doi:10.1017/S0033291713001372

Weber, B. A., Roberts, B. L., Yarandi, H., Mills, T. L., Chumbler, N. R., & Wajsman, Z. (2007). The impact of dyadic social support on self-efficacy and depression after radical prostatectomy. <i>Journal of Aging and Health, 19</i>, 630-645. doi:10.1177/0898264307300979

White, V. M., Macvean, M. L., Grogan, S., D'Este, C., Akkerman, D., Ieropoli, S., … Sanson-Fisher, R. (2012). Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial. <i>Psycho-Oncology, 21</i>, 1053-1062. doi:10.1002/pon.2019

Würtzen, H., Dalton, S. O., Elsass, P., Sumbundu, A. D., Steding-Jensen, M., Karlsen, R. V., … Johansen, C. (2013). Mindfulness significantly reduces self-reported levels of anxiety and depression: Results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. <i>European Journal of Cancer, 49</i>, 1365-1373.

Wyatt, G., Sikorskii, A., Rahbar, M. H., Victorson, D., & You, M. (2012). Health-related quality-of-life outcomes: A reflexology trial with patients with advanced-stage breast cancer. <i>Oncology Nursing Forum, 39</i>, 568-577. doi:10.1188/12.ONF.568-577

Wysocki, W. M., Mitus, J., Komorowski, A. L., & Karolewski, K. (2012). Impact of preoperative information on anxiety and disease-related knowledge in women undergoing mastectomy for breast cancer: A randomized clinical trial. <i>Acta Chirurgica Belgica, 112</i>, 111-115.

Yang, C. Y., Tsai, J. C., Huang, Y. C., & Lin, C. C. (2010). Effects of a home-based walking program on perceived symptom and mood status in postoperative breast cancer women receiving adjuvant chemotherapy. <i>Journal of Advanced Nursing, 67</i>, 158-168.

Yim, V. W., Ng, A. K., Tsang, H. W., & Leung, A. Y. (2009). A review on the effects of aromatherapy for patients with depressive symptoms. <i>Journal of Alternative and Complementary Medicine, 15</i>, 187-195. doi:10.1089/acm.2008.0333

Zhang, J., Yang, K. H., Tian, J. H., & Wang, C. M. (2012). Effects of yoga on psychologic function and quality of life in women with breast cancer: A meta-analysis of randomized controlled trials. <i>Journal of Alternative and Complementary Medicine, 18</i>, 994-1002. doi:10.1089/acm.2011.0514

Zhou, K. N., Li, X. M., Yan, H., Dang, S. N., & Wang, D. L. (2011). Effects of music therapy on depression and duration of hospital stay of breast cancer patients after radical mastectomy. <i>Chinese Medical Journal, 124</i>, 2321-2327.

Zimmermann, T., Heinrichs, N., & Baucom, D. H. (2007). Does one size fit all? Moderators in psychosocial interventions for breast cancer patients: A meta-analysis. <i>Annals of Behavioral Medicine, 34</i>, 225-239. doi:10.1007/BF02874548