Computerized Cognitive Behavior Therapy in Treating Depression in Patients With Cancer

PRIMARY OBJECTIVES:

I. Establish the efficacy of computerized cognitive behavior therapy ("Beating the Blues") in
reducing symptoms of depression and remission of major depressive disorder (MDD) in cancer
patients.

II. Test the feasibility of implementation and patient acceptability of online computerized
cognitive behavior therapy for cancer patients with major depressive disorder (MDD).

III. Test moderators (cancer specific stress, MDD history, anxiety disorder comorbidity, and
homework compliance) of treatment outcome.

OUTLINE: Patients are randomized to 1 of 2 groups.

GROUP I (IMMEDIATE TREATMENT): Patients undergo computerized cognitive behavior therapy
consisting of 45-60 minute sessions once per week for 8 weeks. Patients also complete the
Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD7) at weeks 1,
3, 5, 7 and 8 and complete other questionnaires for 15-30 minutes each that assess
psychosocial and physical symptoms.

GROUP II (WAIT-LIST): Patients are placed on an 8-week wait-list and then undergo
computerized behavior therapy and receive questionnaires as in Group I.

After completion of study intervention, patients are followed up at 2, 4, and 6 months.

Inclusion Criteria:

- A current/prior cancer diagnosis

- A principal diagnosis of major depressive disorder (MDD)

- Able and willing to give informed consent

- Have access to a computer with an internet connection at home

Exclusion Criteria:

- History of bipolar affective disorder or psychosis

- History of substance dependence in the past six months

- Subnormal intellectual potential (intelligence quotient [IQ] below 80)

- Current suicide risk or significant intentional self-harm in the last six months
sufficient to preclude treatment on an outpatient basis

- Inability to read and write English