The efficacy of cognitive behavioral therapy for mental health and quality of life among individuals diagnosed with cancer: A systematic review and meta-analysis

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-08-21 DOI:10.1002/cam4.70063

Alexander T. Dils, Kathryn O'Keefe, Nada Dakka, Michelle Azar, Meiyan Chen, Anao Zhang

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Abstract

Objective

It has long been documented that cognitive behavioral therapy (CBT) has positive impacts on improving mental health (MH) and quality of life (QoL) in the general population, but investigations on its effect on cancer survivors remain limited, especially for QoL outcomes. The purpose of this meta-analysis is to investigate the effects of CBT as compared to control on cancer patients' MH and QoL outcomes. Control is defined in this study as standard therapy, waitlist control, and active/alternative therapy.

Methods

In total, 154 clinical trials creating a sample size of 1627 individuals were collected. Analysis focusing on MH and QoL excluded 29 clinical trials resulting in a final analysis of 132 clinical trials (and 1030 effect sizes). R Statistical Software (version 4.2.2) and the robumeta package were utilized to complete analysis, which entailed robust variance estimation (RVE) in intercept-only meta-regression, and univariate meta-regression (for moderator analysis).

Results

Across 132 clinical trials and 1030 effect size estimates, we identified that CBT moderately improves MH and QoL in cancer patients d = 0.388, 95% CI 0.294–0.483, p < 0.001. Additionally, age and delivery format can influence the efficacy of CBT in this patient population.

Conclusions

CBT statistically improves the MH and QoL psychosocial parameters in cancer patients with greater efficacy in younger patients. Important clinical and intervention-related factors, that is, age and delivery, should be considered when oncologists consider CBT as a psychotherapeutic intervention for individuals with cancer.

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认知行为疗法对确诊癌症患者的心理健康和生活质量的疗效：系统回顾与荟萃分析。

目的：长期以来，认知行为疗法（CBT）对改善普通人群的心理健康（MH）和生活质量（QoL）有着积极的影响，但对其对癌症幸存者影响的调查仍然有限，尤其是对 QoL 结果的调查。本荟萃分析旨在研究 CBT 与对照组相比对癌症患者心理健康和 QoL 结果的影响。本研究将对照组定义为标准疗法、候补对照组和积极/替代疗法：共收集了 154 项临床试验，样本量达 1627 人。以心理健康和 QoL 为重点的分析排除了 29 项临床试验，最终分析了 132 项临床试验（和 1030 个效应大小）。利用 R 统计软件（4.2.2 版）和 robumeta 软件包完成分析，其中包括仅截距元回归的稳健方差估计（RVE）和单变量元回归（用于调节因子分析）：在 132 项临床试验和 1030 个效应大小估计中，我们发现 CBT 可适度改善癌症患者的心理健康和 QoL d = 0.388，95% CI 0.294-0.483，p 结论：CBT 在统计学上可改善癌症患者的心理健康和 QoL：据统计，CBT 可改善癌症患者的心理健康和 QoL 心理社会参数，对年轻患者的疗效更好。当肿瘤学家考虑将 CBT 作为癌症患者的心理治疗干预时，应考虑重要的临床和干预相关因素，即年龄和分娩。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.