Depression

This is an overview of CAM treatments that have been evaluated by CAM Cancer for depression. The CAM treatments have been categorized according to the currently available level of evidence. Please click on the different categories to view the assessment efficacy and safety of the outcomes. Please note that this is not a list of recommended treatments

Please also see our summaries on  Anxiety – Depression – Distress – Mood – Stress 

Massage (Classical/Swedish)

Efficacy

The available evidence is contradictory about the effect of massage on depression. Improved depression has been reported with various massage interventions, but this is not consistent across all studies and appears to be dependent on participant motivation or to be short-term. The evidence is derived from seven SRs, including 7 to 41 mixed-designed studies. low-quality evidence.

Safety

Generally considered safe when administered by a qualified professional. Contraindications include strong forceful massage in patients suffering from haemorrhagic disorders, low platelet counts, and blood thinning medication.

Read the full version of the  Massage (Classical/ Swedish) summary.

Mindfulness

Efficacy

Breast cancer: The evidence suggests MBSR to be effective for depression. Six SRs, including 7 – 14 mixed-designed studies, were assessed to reach this conclusion: high-quality evidence for short-term effects, moderate quality for medium-term effects, and no evidence for long-term effects.

Evidence also suggests MBCT might also improve depression as reported by 2 RCT (n= 112, n= 70).

Mixed cancer types: The evidence suggests MBSR has positive short-term effects on depression but no long-term effects. Three SRs (n=7 RCTs, n=29 RCTs, n=28 RCTs) assessed the effect of mindfulness among patients with mixed cancer types.

Children and adolescents: The evidence suggests MBSR to be effective for depression among mixed types of cancer patients. The evidence is reported by an SR (n=4 mixed studies), but the findings are limited by the methodological flaws of the included studies low-quality evidence.

Safety

Mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are generally considered to be safe in supportive cancer care. However, no rigorous assessment of the safety of mindfulness-based approaches in cancer patients is available.

Read the full version of the  Mindfulness summary.

Music Interventions

Efficacy

The evidence suggests music therapy and music medicine to be moderately effective on depression compared to usual care, including during active cancer treatment, although not during surgery. Based on four SRs, including 19 – 30 mixed-designed studies, and 2 additional RCTs (n=60, n=60).

Safety

Generally considered safe with no safety issues on record. Caution is advised for acutely distressed and/or emotionally fragile patients, particularly in patients with serious and life-threatening cancers.

Read the full version of the Music therapy summary.

Autogenic therapy

Efficacy

Few trial data are available on the effect of autogenic therapy (AT) on depression. The available evidence derives from one small pilot RTC (n=31). The RCT found significant improvements in anxiety and depression (HADS) with AT added to standard care but has limitations including small sample size.

Safety

The safety of autogenic therapy has not been systematically assessed. No adverse events were reported in the studies analysed for this summary.Concerns exist for children under the age of five, individuals with schizophrenia or who are actively psychotic.

Read the full version of the Autogenic therapy summary.

Mindfulness

Efficacy

Children and adolescents: The evidence suggests MBSR to be effective for depression among mixed types of cancer patients. The evidence is reported by an SR (n=4 mixed study designs), but the findings are limited by the methodological flaws of the included studies low-quality evidence.

Safety

Mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are generally considered to be safe in supportive cancer care. However, no rigorous assessment of the safety of mindfulness-based approaches in cancer patients is available.

Read the full version of the  Mindfulness summary.

Progressive Muscle Relaxation

Efficacy

The available evidence suggests PMR to be effective on depression but is limited by methodological shortcomings. The results derive from one SR (n=2 RCTs), 3 RCTs (n=147, n=50, n=60), and one non-randomized trial (n=138).

Safety

Some concern has been raised about the use of relaxation therapy interventions among individuals who have a history of psychiatric disorders.Generally considered safe when administered by a qualified practitioner.

Read the full version of the Progressive Muscle Relaxation summary.

Qigong

Efficacy

The evidence is contradictory on the effect of qigong on depression. One SR (17 mixed studies) and RCT (n=80) concluded that qigong reduces the symptoms of depression, and two SRs (SR 1=22 mixed study designs, SR 2=11 RCTs) reported mixed results among the studies included.

Safety

As it is a moderate form of aerobic exercise, it may be beneficial for people to check with their health practitioner if they have a known heart condition, severe osteoporosis or musculoskeletal difficulties.

Generally considered safe when administered by a qualified practitioner.

Read the full version of the Qigong summary.

Tai chi

Efficacy

The evidence is contradictory on the effect of tai chi on depression. Tai chi had little effect or no difference in reducing depressive symptoms when compared with exercise training, usual care. These findings are based on a SR including 4 RCTs assessing tai chi for depression; the studies were of high risk of bias; low-quality evidence.

Safety

Generally considered safe when administered by a qualified practitioner. As it is a moderate form of aerobic exercise, it may be beneficial for people to check with their health practitioner if they have a known heart condition, severe osteoporosis or musculoskeletal difficulties.

Read the full version of the Tai chi summary.

Yoga

Efficacy

Breast cancer: the evidence is contradictory on the effect of yoga on depression. Effects on depression are positive when yoga interventions are compared to controls.

For comparison with no treatment control, low quality evidence showed no significant difference. These findings are based on seven SRs (n=24 RCTs, n=26 RCTs, n=26 RCTs, n=10 RCTs, n=16 RCTs, n=3 RCTs, n=7 RCTs).

Other cancers: the evidence is contradictory on the effect of yoga on depression. Four RCTs (n=62, n=52, n=40, n=173) have reported positive effects. In one trial, positive effects were seen only at 10 weeks, and 2 RCTs (n=54, n=70) found no significant difference between yoga and control groups.

Read the full version of the Yoga summary.

Safety

Generally considered safe when administered by a qualified practitioner. Few adverse events are reported in clinical trials and serious adverse effects appear to be rare. Overall injury rates are comparable to other exercise types.

 

Aromatherapy

Efficacy

The evidence suggests aromatherapy not to be effective on depression. The results are based on two SRs (n=43 mixed study designs, n=19 mixed study designs) and two additional RTCs (n=39, n=57); low-quality evidence.

Safety

Generally safe and only associated with minimal adverse effects when used in appropriate dilutions. Allergic reactions can occur with all oils. Should not be used undiluted.

Read the full version of the aromatherapy summary.

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