Jassim, G.A., Whitford, D.L., Hickey, A., & Carter, B. (2015). Psychological interventions for women with non-metastatic breast cancer. Cochrane Database of Systematic Reviews, 5, CD008729.
STUDY PURPOSE: To evaluate evidence for psychological interventions in women with breast cancer
TYPE OF STUDY: Meta analysis and systematic review
PHASE OF CARE: Multiple phases of care
In 24 of 28 trials, cognitive behavioral therapy was the basis of the intervention. Most studies had unclear risk of bias, and for studies aimed at anxiety and depression, quality of the evidence was graded as low. Comparison of CBT versus control across multiple studies for depression showed an overall standard mean difference (SMD) of -1.01 (p = 0.02) in favor of the CBT intervention. Only two studies examined CBT delivered individually, showing no significant benefit and high heterogeneity. Examined separately, group CBT also did not consistently show significant benefit for depression. Eight studies looked at change in anxiety. Both individual- and group-delivered CBT showed significant benefit, with an overall SMD -10.48 (p = 0.0006). CBT showed a significant positive effect for stress, and only marginal effect on quality of life.
Findings showed overall benefit of CBT for anxiety and depression in women with early-stage breast cancer
Although studies have shown that psychological interventions are more effective for individuals with psychological problems, the studies included here excluded women with psychological morbidity. There was high heterogeneity, and most studies were of low quality.
CBT delivered in a group or individual setting has been shown to have a positive effect on depression and anxiety among women with early-stage breast cancer. The strength of these results is limited by the relatively low quality of studies included in this review.