Abstract
Breast cancer is the most prevalent oncological disease among women, and it represents the second oncological cause of death. Many studies have considered the quality of life in people with breast cancer because this condition has high comorbidity with mental distress, anxiety, affective disorders and depression. Psychological interventions can reduce the stressful consequences of both the diagnosis and the medical treatments of breast cancer. However, different methods (e.g., group or individual therapy) and focus (e.g., improving personal skills or increasing emotional well-being) do not help to identify which type of psychological therapy can be more effective in improving quality of life in patients with breast cancer. This study was aimed to systematically review and compare, by means of a meta-analysis, the efficacy of cognitive behavioural, supportive-expressive or psycho-educational treatments in women with breast cancer, focusing on anxiety, depression, mood and quality of life as outcomes. The PRISMA statement was adopted. MEDLINE, PsycINFO, PUBMED and PsycArticles databases were used, and reference lists were examined for additional publications. In the selection of the articles were included studies considering women between 18 and 65 years who were diagnosed with breast cancer at any stage and under any treatment, and who underwent psychological group interventions. At the end of the systematic review, 45 studies met all inclusion criteria and were analysed in the meta-analysis. The overall effect size was medium, especially considering cognitive behavioural therapy and psycho-educational treatments. However, the studies are characterised by high methodological heterogeneity. Despite some limitations, this review and meta-analysis partially confirm the efficiency of cognitive-behavioural and psycho-educational therapies in the improvement of well-being in women with breast cancer.
Highlights
Breast cancer is the most prevalent oncological disease in women, with a lifetime incidence ratio of one in eight [1,2]
The goals of this study were to assess the clinical effectiveness of psychological treatments on different psychological outcomes in women with a breast cancer diagnosis
Several subgroup analyses about specific variables highlighted an influence of some characteristics of the sample and the methods adopted in the clinical trials, which could have determined the high heterogeneity among the studies as well as the different treatment efficacies
Summary
Breast cancer is the most prevalent oncological disease in women, with a lifetime incidence ratio of one in eight [1,2]. It represents the second oncological cause of death [3,4] and twenty-five per cent of all new cancer diagnoses in women, with a higher incidence in the age range from 55 to 64 years [4,5]. Women with a primary breast cancer diagnosis remain vulnerable to psychological disorders for many years [16,17,18,19], highlighting the high impact of this medical condition in the quality of life of the patients
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