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The effectiveness of cognitive behavioural therapy for depression in women with breast cancer: a systematic review and meta-analysis

Published online by Cambridge University Press:  23 February 2024

Stephania Wieland Open the ORCID record for Stephania Wieland [Opens in a new window] ,
Sarah Melton ,
Anastasios Bastounis Open the ORCID record for Anastasios Bastounis [Opens in a new window]  and
Tim Carter Open the ORCID record for Tim Carter [Opens in a new window]
Stephania Wieland*
Affiliation:
Every Turn Services Ltd, Sir Bobby Robson Way, Newcastle upon Tyne, UK
Sarah Melton
Affiliation:
Derbyshire NHS Foundation Trust, Kingsway Hospital, Derby, UK
Anastasios Bastounis
Affiliation:
School of Health and Related Research (ScHARR), Regent Court, University of Sheffield, Sheffield, UK
Tim Carter
Affiliation:
School of Health Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham, UK
*
Corresponding author: Stephania Wieland; Email: [email protected]
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Abstract

Background:

Depression is a common co-morbidity in women with breast cancer. Previous systematic reviews investigating cognitive behavioural therapy (CBT) for depression in this population based their conclusions on findings from studies with varying and often limited specificity, quality and/or quantity of CBT within their interventions.

Aim:

To determine the effectiveness of a specific, well-evidenced CBT protocol for depression in women with breast cancer.

Method:

Online databases were systematically searched to identify randomised controlled trials (RCTs) testing CBT (aligned to Beck’s protocol) as a treatment for depression in women with breast cancer. Screening, data extraction and risk of bias assessment were independently undertaken by two study authors. Both narrative synthesis and meta-analysis were used to analyse the data. The meta-analysis used a random effects model to compare CBT with non-active/active controls of depression using validated, self-report measures.

Results:

Six RCTs were included in the narrative synthesis, and five in the meta-analysis (n = 531 participants). Overall, CBT demonstrated an improvement in depression scores in the CBT condition versus active and non-active controls at post-intervention (SMD = –0.93 [95% CI –1.47, –0.40]). Narratively, five out of six RCTs reported statistically significant improvements in depression symptoms for CBT over control conditions for women with breast cancer.

Conclusion:

CBT aligned to Beck’s protocol for depression appears effective for treating depression in women with breast cancer. However, further research is needed for women with stage IV breast cancer. The clinical recommendation is that therapists utilise Beck’s CBT protocol for depression, whilst considering the complex presentation and adapt their practice accordingly.

Keywords

Breast cancerCBTCognitive behavioural therapyDepressionOncologySystematic review
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 52 , Issue 4 , July 2024 , pp. 394 - 413
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

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