Preventing anxiety and depression in gynaecological cancer: a randomised controlled trial

Objective To examine the effect of counselling and relaxation intervention on psychological symptoms in patients with gynaecological cancer between the post-operative period and the six-week review. Design Randomised controlled trial. Participants Fifty-three patients with gynaecological cancer. Setting Three Australian tertiary referral hospitals. Methods Fifty-three patients were randomised to control or intervention and completed the baseline Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire-28 (GHQ-28) questionnaires. The intervention consisted of a relaxation and counselling session performed by a senior doctor. Follow up questionnaires were completed at six weeks. Demographic and tumour data were collated independently. Results Complete data were available on 50 patients. There were no significant differences in demographic, social support or tumour characteristics between the two groups. Multivariate analysis determined that only the intervention and baseline score were significant predictors of outcome. The intervention was associated with a significant reduction in total HADS score (P = 0.002). The reduction was seen in both anxiety and moderate depression subscales (P = 0.001 and P = 0.02). The intervention was also associated with a significant reduction in total GHQ-28 score and in three of the four subscale scores (somatisation, anxiety and personality development; all P < 0.02). However, no significant difference was found in the fourth subscale of major depression. Conclusion A relaxation and counselling intervention performed by a treating doctor reduces psychological , symptoms in women with a new diagnosis of gynaecological cancer.