Changes in Cortisol Levels before and after Supportive Psychotherapy in Patients with Comorbid Cervical Cancer Distress with Depression Type

Abstract

Objective: To prove the success of supportive psychotherapy that was provided as a distress therapy on advanced cervical cancer. Knowing the prevalence of distress type of depression in patient with epithelial cervical cancer, proving the benefits of psychotherapy supportive for distress can decreasing cortisol level in cervical cancer patient, can assess distress thermometer score, HAM-D17 score and scoring incident predictors of distress with depression type. Methods: There were 32 subjects from 71 advanced cervical cancer patients had mild-moderate depression. Then randomization blocking was performed to determine a subject who entered the treatment group (n = 16) who got supportive psychotherapy or control group who got common psychotherapy (n = 16). All of participants assessed the distress level with cortisol value, distress thermometer score, and HAM-D17 score before and after they got supportive psychotherapy. Results: After the intervention of psychotherapy in the treatment group decreased HAM-D17 score, the average decline 7.53 (SB 3.34). The mean decreasing in the control group was 3.98 (SB 2.85). There is a significant difference in mean reduction in HAM-D17 scores on treatment and control groups with p = 0.003 (p <0.005). There was decreasing blood cortisol level in the treatment group amounted to 39.43, while the control group there was a drop of 1.59. The reduction of cortisol level in the treatment group and the control has a pvalue 0.302. After got supportive psychotherapy, found a decreasing the average value of the thermometer distress in the treatment group 3.02 and the control group 2.51, with a p value more than 0.492. Conclusion: There were 45% of cervical cancer patients in the clinic experiencing distress disorder with depressive type. The blood cortisol level could be decreased by giving supportive psychotherapy with a mean decrease of 39.43 nmol/l. There was a significant reduction in the level of depression (HAM-D17 score) of 7.53 points and distress thermometer impairment by 3 points after given supportive psychotherapy. Obtained scoring predictors for the occurrence of distress type of depression in patients with advanced cervical cancer with a sensitivity of 46.15% and a specificity of 89.47%. [Indones J Obstet Gynecol 2018; 6-3: 179-187] Keywords: cervical cancer, cortisol, distress, distress thermometer, HAM-D17 score