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Driessen HP, Morsink S, Busschbach JJ, Hoogendijk WJ, Kranenburg LW. Eye Movement Desensitization and Reprocessing (EMDR) treatment in the medical setting: a systematic review. Eur J Psychotraumatol 2024; 15:2341577. [PMID: 38747113 PMCID: PMC11097707 DOI: 10.1080/20008066.2024.2341577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/15/2024] [Indexed: 05/18/2024] Open
Abstract
Background: Literature points towards the potential benefits of the application of Eye Movement and Desensitization Processing (EMDR)-therapy for patients in the medical setting, with cancer and pain being among the domains it is applied to. The field of applying EMDR-therapy for patients treated in the medical setting has evolved to such an extent that it may be challenging to get a comprehensive overview.Objective: This systematic literature review aims to evaluate the use and effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in patients treated in the medical setting.Methods: We performed a literature search following the PRISMA guidelines. Studies were included if the effectiveness of EMDR-therapy was assessed in adult patients treated in a medical setting. Excluded were patients exclusively suffering from a mental health disorder, without somatic comorbidity. A risk of bias analysis was performed. This review was registered on PROSPERO (CRD42022325238).Results: Eighty-seven studies, of which 26 (pilot)-RCTs were included and categorized in 14 medical domains. Additionally, three studies focusing on persistent physical complaints were included. Most evidence exists for its application in the fields of oncology, pain, and neurology. The overall appraisal of these studies showed at least moderate to high risks of bias. EMDR demonstrated effectiveness in reducing symptoms in 85 out of 87 studies. Notably, the occurrence of adverse events was rarely mentioned.Conclusions: Overall, outcomes seem to show beneficial effects of EMDR on reducing psychological and physical symptoms in patients treated in a medical setting. Due to the heterogeneity of reported outcomes, effect sizes could not be pooled. Due to the high risk of bias of the included studies, our results should be interpreted with caution and further controlled high-quality research is needed.
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Affiliation(s)
- Helen P.A. Driessen
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sid Morsink
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan J.V. Busschbach
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Witte J.G. Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Leonieke W. Kranenburg
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Keenan E, Morris R, Vasiliou VS, Thompson AR. A qualitative feasibility and acceptability study of an acceptance and commitment-based bibliotherapy intervention for people with cancer. J Health Psychol 2024; 29:410-424. [PMID: 38158736 PMCID: PMC11005316 DOI: 10.1177/13591053231216017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Self-directed bibliotherapy interventions can be effective means of psychological support for individuals with cancer, yet mixed findings as to the efficacy of these interventions indicate the need for further research. We investigated the experience of individuals with cancer after using a new self-help book, based on Acceptance and Commitment Therapy (ACT). Ten participants with cancer (nine females and one male, 40-89 years old) were given access to a bibliotherapy self-help ACT-based book and participated in post-intervention semi-structured interviews. Five themes were generated from reflexive thematic analysis: (1) The value of bibliotherapy (2) Timing is important (3) Resonating with cancer experiences (4) Tools of the book (5) ACT in action. The book was found to be acceptable (self-directed, accessible, understandable content, good responsiveness to exercises) and feasible (easy to use, ACT-consistent). Although not explicitly evaluated, participants' reports indicated defusion, present moment awareness, and consideration of values, as the ACT processes that contributed to adjustment, via helping them to regain control over their lives and become more present within the moment. Findings also indicate that the intervention may be best accessed following completion of initial medical treatment.
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Affiliation(s)
- Emma Keenan
- Cardiff and Vale University Health Board and Cardiff University
| | - Reg Morris
- Cardiff and Vale University Health Board and Cardiff University
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Anderson D, Jones V. Psychological interventions for cancer-related post-traumatic stress disorder: narrative review. BJPsych Bull 2024; 48:100-109. [PMID: 37288666 PMCID: PMC10985725 DOI: 10.1192/bjb.2023.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 03/31/2023] [Accepted: 04/23/2023] [Indexed: 06/09/2023] Open
Abstract
AIMS AND METHOD This narrative review updates the evidence base for cancer-related post-traumatic stress disorder (PTSD). Databases were searched in December 2021, and included EMBASE, Medline, PsycINFO and PubMed. Adults diagnosed with cancer who had symptoms of PTSD were included. RESULTS The initial search identified 182 records, and 11 studies were included in the final review. Psychological interventions were varied, and cognitive-behavioural therapy and eye movement desensitisation and reprocessing were perceived to be most efficacious. The studies were also independently rated for methodological quality, which was found to be hugely variable. CLINICAL IMPLICATIONS There remains a lack of high-quality intervention studies for PTSD in cancer, and there is a wide range of approaches to managing these conditions, with a large heterogeneity in the cancer populations examined and methodologies used. Specific studies designed with patient and public engagement and that tailor the PTSD intervention to particular cancer populations under investigation are required.
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Affiliation(s)
| | - Victoria Jones
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Sherborne V, Wood E, Mayland CR, Gardiner C, Lusted C, Bibby A, Tod A, Taylor B, Ejegi-Memeh S. The mental health and well-being implications of a mesothelioma diagnosis: A mixed methods study. Eur J Oncol Nurs 2024; 70:102545. [PMID: 38522172 DOI: 10.1016/j.ejon.2024.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/21/2024] [Accepted: 03/03/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE Mesothelioma is an incurable, asbestos-related cancer with a poor prognosis. There is scant evidence about the mental health and well-being impacts on patients and carers living with the illness. This study aimed to investigate mesothelioma's impact on mental health and well-being and the scale of mental health conditions in patients and informal carers. METHODS A mixed-methods design was used: a cross-sectional survey of mesothelioma patients and informal carers plus semi-structured interviews with patients and carers. The survey used validated scales collecting data on mental health aspects of mesothelioma: the EQ5D to assess health-related quality-of-life; the Hospital Anxiety and Depression scale; the PCL-5 to assess Posttraumatic Stress; and the Posttraumatic Growth Inventory. The datasets were integrated during analysis. RESULTS 96 useable survey responses were received. A clinical level of depression was reported by 29 participants (30.21%), of anxiety by 48 (50%), of posttraumatic distress disorder by 32 (33.33%), and of posttraumatic growth by 34 (35.42%). Carers had worse scores than patients. Three main themes were developed from interviews with 10 patients and 11 carers: 'Prognosis', 'Support from services', and 'Social connections and communication'. CONCLUSIONS Healthcare professionals delivering a mesothelioma diagnosis require regular training in communication skills plus updating in current treatment options, so they provide an appropriate mix of realism and hope. Better signposting to mental health support is needed for patients and carers. Our introduction of posttraumatic growth into the mesothelioma literature is novel. We recommend specialist nurses are trained to recognise, understand, and foster posttraumatic growth.
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Affiliation(s)
- Virginia Sherborne
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK.
| | - Emily Wood
- Division of Population Health, School of Medicine and Population Health, The University of Sheffield, UK
| | - Catriona R Mayland
- Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, UK
| | - Clare Gardiner
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Caitlin Lusted
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Anna Bibby
- Academic Respiratory Unit, University of Bristol and North Bristol NHS Trust, Bristol, UK
| | - Angela Tod
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Bethany Taylor
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Stephanie Ejegi-Memeh
- Mesothelioma UK Research Centre, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
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Neill EL, Zarling A, Weems CF. Therapist use of cognitive behavior therapy and eye movement desensitization and reprocessing components for the treatment of posttraumatic stress disorder in practice settings. Front Psychol 2023; 14:1158344. [PMID: 37928599 PMCID: PMC10621788 DOI: 10.3389/fpsyg.2023.1158344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Treatment practice guidelines for posttraumatic stress disorder (PTSD) recommend both Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavior Therapy (CBT); however, implementation in practice setting remains challenging. Here we aim to foster implementation efforts for PTSD by identifying the relative use of the various components of empirically supported treatments by therapists and the characteristics that predict their use. Methods Surveyed 346 therapists (84.07% female) of whom 272 participants (78.61%) were trained primarily in CBT and 135 participants (39.02%) were trained in primarily in EMDR. Assessed relative use of various EMDR and CBT components as well as several training and personality factors. Results Psychoeducation about trauma was the most common element used. "Off label" use of components was also identified with application of EMDR techniques to other diagnoses. Findings also suggest underutilization of in vivo exposure techniques across therapists. EMDR therapists reported relatively high use of core EMDR techniques (i.e., greater use of EMDR core techniques). Big five personality factors, therapy efficacy, and anxiety were associated with differential component use. Discussion Results identify trends in empirically supported component use and therapist characteristics that are associated with the use of various techniques for PTSD. The findings suggest implementation efforts could foster training in underused techniques, address barriers to their utilization and develop knowledge of effective packages of components.
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Affiliation(s)
- Erin L. Neill
- Human Development and Family Studies, Iowa State University, Ames, IA, United States
| | | | - Carl F. Weems
- Human Development and Family Studies, Iowa State University, Ames, IA, United States
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Koizumi T, Sugishita Y, Suzuki-Takahashi Y, Nara K, Miyagawa T, Nakajima M, Sugimoto K, Futamura M, Furui T, Takai Y, Matsumoto H, Yamauchi H, Ohno S, Kataoka A, Kawai K, Fukuma E, Nogi H, Tsugawa K, Suzuki N. Oncofertility-related psycho-educational therapy for young adult patients with breast cancer and their partners: Randomized controlled trial. Cancer 2023; 129:2568-2580. [PMID: 37082910 DOI: 10.1002/cncr.34796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND A couples' psycho-educational program called Oncofertility! Psycho-Education and Couple Enrichment (O!PEACE) therapy was created and its effect when provided before cancer treatment was examined. METHODS This multicenter randomized controlled trial with nonmasking, parallel two-group comparison enrolled women aged 20 to 39 years with early-stage breast cancer and their partners. They were randomly assigned to receive O!PEACE (37 couples) or usual care (37 couples). Primary end points were cancer-related posttraumatic stress symptoms, symptoms of depression, and anxiety. Secondary end points were stress-coping strategies, resilience, and marital relationship. RESULTS Women receiving psycho-educational therapy had significantly reduced Impact of Event Scale-revised version for Japanese scores (p = .011, ηp 2 = = .089). For patients with Impact of Event Scale-revised version for Japanese scores at baseline ≥18.27, O!PEACE therapy improved these scores when compared with usual care (U = 172.80, p = .027, r = 0.258). A >5-point reduction was present in 59.3% and 30% of women in the O!PEACE therapy and usual-care groups, respectively. For partners, O!PEACE therapy significantly improved stress-coping strategies (95% CI, -0.60 to -0.05; p = .018, ηp 2 = = .074) and escape-avoidance marital communication (95% CI, -0.33 to -0.08; p = .001, ηp 2 = .136). O!PEACE therapy significantly improved the partners' support (95% CI, 0.10-0.50; p = .001, ηp 2 = .127), the rate of receiving fertility preservation consultations, and knowledge levels. CONCLUSIONS O!PEACE therapy before cancer treatment can improve posttraumatic stress symptoms, stress-coping behavior, and marital relationships. Larger sample sizes and longer term follow-up are required. PLAIN LANGUAGE SUMMARY A psycho-educational program, the Oncofertility! Psycho-Education and Couple Enrichment (O!PEACE) therapy program was developed and evaluated for women diagnosed with breast cancer and their partners. A multicenter randomized controlled trial showed that the O!PEACE psycho-educational therapy, with only two precancer treatment sessions, can reduce cancer-related posttraumatic stress symptoms and improve oncofertility knowledge and marital relationships in young adult patients with breast cancer. The therapy could also improve stress-coping strategies in marital communications with their partners. Couples may use O!PEACE psycho-educational therapy to consider fertility preservation and improve their psychosocial aspects.
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Affiliation(s)
- Tomoe Koizumi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Yodo Sugishita
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yuki Suzuki-Takahashi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- Department of Frontier Medicine, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Kazuko Nara
- Department of Clinical Psychology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomoko Miyagawa
- Department of Clinical Psychology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | | | - Kouhei Sugimoto
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Manabu Futamura
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Gifu, Japan
| | - Tatsuro Furui
- Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, Gifu, Gifu, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical University Saitama Medical Center, Kawagoe, Saitama, Japan
| | - Hiroshi Matsumoto
- Lacteal Gland Surgery Department, Saitama Cancer Center, Kitaadachi, Saitama, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Chuo, Tokyo, Japan
| | - Shinji Ohno
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo, Japan
| | - Akemi Kataoka
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto, Tokyo, Japan
| | - Kiyotaka Kawai
- Kameda IVF Clinic, Chiba, Chiba, Japan
- Assisted Reproductive Technology Center, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Eisuke Fukuma
- Breast Center, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Hiroko Nogi
- Department of Surgery, Jikei University School of Medicine, Minato, Tokyo, Japan
| | - Koichiro Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Zolfa R, Moradi A, Mahdavi M, Parhoon H, Parhoon K, Jobson L. Feasibility and acceptability of written exposure therapy in addressing posttraumatic stress disorder in Iranian patients with breast cancer. Psychooncology 2023; 32:68-76. [PMID: 36116086 DOI: 10.1002/pon.6037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study examined the feasibility and acceptability of written exposure therapy (WET) in reducing symptoms of posttraumatic stress disorder (PTSD) in Iranian women with breast cancer. Secondary aims included examining the influence of WET on quality of life (QoL), overgeneral memory and illness perceptions. METHOD Forty-six females with breast cancer and clinical symptoms of PTSD referred to the Razi Hospital in Rasht, Iran were randomly assigned to either WET (n = 23) or control (n = 23) groups. WET is a 5-session low-intensity exposure-based intervention for treating PTSD. The control group had no additional contact. Measures assessing PTSD, illness perceptions, overgeneral memory, and QoL were administered at baseline, post-intervention and 3-month follow-up. RESULTS Acceptability of WET was high; all participants completed all WET sessions. At post-intervention, 95.65% of the WET group met criteria for reliable change and 100% met criteria for minimal clinically important difference (MCID) and clinically significant change in PTSD symptom improvement. At follow-up, all WET participants met criteria for reliable change, MCID and clinically significant change in PTSD symptom improvement. No participants in the control group met reliable change, MCID or clinically significant change. The WET group had improved QoL and memory specificity and decreased threatening illness perceptions at post-intervention and follow-up when compared to controls. CONCLUSION WET may be a useful intervention for use with breast cancer patients with PTSD symptoms and may be an important adjunct to medical and pharmacological treatments, particularly in low- and middle-income countries. This study indicates further research in this area is warranted.
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Affiliation(s)
- Reihane Zolfa
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran
| | - Alireza Moradi
- Kharazmi University and Institute for Cognitive Science Studies, Tehran, Iran
| | - Mohammad Mahdavi
- Kharazmi University and Institute for Cognitive Science Studies, Tehran, Iran
| | - Hadi Parhoon
- Department of Psychology, Razi University, Kermanshah, Iran
| | - Kamal Parhoon
- Postdoc Researcher in Cognitive Psychology, Kharazmi University, Tehran, Iran
| | - Laura Jobson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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Bradley-Garcia M, Winocur G, Sekeres MJ. Episodic Memory and Recollection Network Disruptions Following Chemotherapy Treatment in Breast Cancer Survivors: A Review of Neuroimaging Findings. Cancers (Basel) 2022; 14:cancers14194752. [PMID: 36230678 PMCID: PMC9563268 DOI: 10.3390/cancers14194752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Memory disturbances are amongst the most common and disruptive symptoms of chemotherapy-related cognitive impairment. Chemotherapy treatments commonly cause neurotoxicity within the hippocampus, creating a vulnerability to memory impairment. Most clinical assessments of long-term memory in breast cancer survivors assess basic verbal and visual memory processing, and do not capture the complexities of everyday event memories, including episodic and autobiographical memory. This review focuses on structural and functional neuroimaging studies identifying disruptions in the hippocampus and recollection network, and related episodic memory impairments in chemotherapy-treated breast cancer survivors. We argue for the need to better characterize memory dysfunction following chemotherapy treatments. Given the importance of episodic and autobiographical memory to a person’s personal history and quality of life, an under-appreciation of how this memory domain is impacted by standard cancer treatments potentially diminishes the negative experiences of breast cancer survivors, and neglects cognitive problems that could benefit from intervention strategies. Abstract Long-term memory disturbances are amongst the most common and disruptive cognitive symptoms experienced by breast cancer survivors following chemotherapy. To date, most clinical assessments of long-term memory dysfunction in breast cancer survivors have utilized basic verbal and visual memory tasks that do not capture the complexities of everyday event memories. Complex event memories, including episodic memory and autobiographical memory, critically rely on hippocampal processing for encoding and retrieval. Systemic chemotherapy treatments used in breast cancer commonly cause neurotoxicity within the hippocampus, thereby creating a vulnerability to memory impairment. We review structural and functional neuroimaging studies that have identified disruptions in the recollection network and related episodic memory impairments in chemotherapy-treated breast cancer survivors, and argue for the need to better characterize hippocampally mediated memory dysfunction following chemotherapy treatments. Given the importance of autobiographical memory for a person’s sense of identity, ability to plan for the future, and general functioning, under-appreciation of how this type of memory is impacted by cancer treatment can lead to overlooking or minimizing the negative experiences of breast cancer survivors, and neglecting a cognitive domain that may benefit from intervention strategies.
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Affiliation(s)
| | - Gordon Winocur
- Rotman Research Institute, Baycrest Centre, Toronto, ON M6A 2E1, Canada
- Department of Psychology, Department of Psychiatry, University of Toronto, Toronto, ON M5S 3G3, Canada
- Department of Psychology, Trent University, Peterborough, ON K9J 7B8, Canada
| | - Melanie J. Sekeres
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence:
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Zhang A, Wang K, Blumenstein K, Brose A, Kemp C, Meister D, Solomon P. For whom and what outcomes does cognitive-behavioral-therapy work among cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2022; 30:8625-8636. [PMID: 36040671 DOI: 10.1007/s00520-022-07337-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To perform a systematic review and meta-analysis of CBT for individuals diagnosed with cancer across a broad range of outcome domains, i.e., functional health, psychological health, health behaviors, social relational, and general wellness. METHODS A comprehensive search of 7 databases, 91 published reviews, and 4 professional websites was performed on August 30th, 2021. English-language clinical trials of CBT for cancer patients/survivors were included. Studies were independently screened, and data were extracted by 2 reviewers, and discrepancies were resolved by consensus among the investigative team. A total of 151 clinical trials (154 articles) published between 1986 and 2021 were included in the analysis. RESULTS CBT was overall effective for cancer patients/survivors in the domains of functional health, g = 0.931, p < 0.001, psychological health, g = 0.379, p < 0.001, and general wellness, g = 0.257, p < 0.001, but ineffective in domains of health behaviors, g = 0.792, p > 0.05, and social relational outcomes, g = 0.319, p > 0.05. Additional subgroup and moderator analyses further revealed CBT's differential treatment effect for different within domain outcomes, across different cancer disease stages, and CBT delivery format. CONCLUSIONS Findings of the study showed that CBT is an effective treatment for individuals diagnosed with cancer. However, treatment effects differ by important disease- and intervention-related factors, which should be considered when recommending CBT for cancer patients/survivors.
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Affiliation(s)
- Anao Zhang
- University of Michigan School of Social Work, 1080 South University Avenue, MI, 48109, Ann Arbor, USA.
- Michigan Medicine Adolescent and Young Adult Oncology Program, Ann Arbor, MI, USA.
| | - Kaipeng Wang
- University of Denver Graduate School of Social Work, CO, Denver, USA
| | - Kate Blumenstein
- Rosalind Franklin University Chicago Medical School, Chicago, IL, USA
| | - Anna Brose
- Wheaton College in Illinois, Chicago, IL, USA
| | - Chris Kemp
- University of Michigan School of Social Work, 1080 South University Avenue, MI, 48109, Ann Arbor, USA
| | - Dalton Meister
- University of Michigan School of Social Work, 1080 South University Avenue, MI, 48109, Ann Arbor, USA
| | - Phyllis Solomon
- University of Pennsylvania School of Social Policy & Practice, PA, Philadelphia, USA
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Portigliatti Pomeri A, La Salvia A, Carletto S, Oliva F, Ostacoli L. EMDR in Cancer Patients: A Systematic Review. Front Psychol 2021; 11:590204. [PMID: 33536968 PMCID: PMC7847844 DOI: 10.3389/fpsyg.2020.590204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Psychological distress is common among patients with cancer, with severe consequences on their quality of life. Anxiety and depression are the most common clinical presentation of psychological distress in cancer patients, but in some cases cancer may represent a traumatic event resulting in posttraumatic stress disorder (PTSD). Currently, Eye Movement Desensitization and Reprocessing (EMDR) therapy is considered an evidence-based treatment for PTSD, but recent studies also showed its effectiveness for anxiety and depression. The aim of the present systematic review is to summarize the current literature on the effect of EMDR on cancer-related psychological distress. Methods: A literature search was conducted for peer-reviewed articles about "EMDR" and "cancer patients" in the following electronic databases: PubMed, MEDLINE, Science Direct, Google Scholar, and Cochrane library. Results: Our search identified 7 studies in which EMDR was used with a total of 140 cancer patients. The psychiatric diagnosis was PTSD in 3 studies. Otherwise, the diagnosis concerned the anxious and depressive disorder spectrum. Overall, EMDR treatment schedules used were highly heterogeneous, with a different number of sessions (from 2 to 12) and a different duration of therapy (up to 4 months). However, across all studies analyzed EMDR therapy was judged to be adequate in reducing symptoms of psychological distress in this population. Conclusions: According to the results of our analysis, the level of evidence regarding EMDR efficacy in cancer patients is limited by the scarcity of studies and their low methodological quality. Although better quality research is needed, available data suggest that EMDR could be a promising treatment for psychological distress in patients with cancer.
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Affiliation(s)
| | - Anna La Salvia
- Department of Oncology, 12 de Octubre University Hospital, Madrid, Spain
| | - Sara Carletto
- Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Torino, Italy
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
| | - Luca Ostacoli
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
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Zerbinati L, Murri MB, Caruso R, Nanni MG, Lam W, De Padova S, Sabato S, Bertelli T, Schillani G, Giraldi T, Fielding R, Grassi L. Post-traumatic Stress Symptoms and Serotonin Transporter (5-HTTLPR) Polymorphism in Breast Cancer Patients. Front Psychiatry 2021; 12:632596. [PMID: 33967853 PMCID: PMC8097040 DOI: 10.3389/fpsyt.2021.632596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: Post-traumatic Symptoms (PTSS) and Post-traumatic Stress Disorder (PTSD) have been reported to affect a quite significant proportion of cancer patients. No study has examined the relationship between serotonin transporter gene-linked polymorphic region (5-HTTLPR) and cancer, including Gene-Environment interactions between this polymorphism and specific causes of distress, such as cancer related problems (CRP) or life stressful events (SLE). Methods: One hundred and forty five breast cancer outpatients participated in the study and were assessed using the Impact of Event Scale (IES), the Problem List (PL) developed by the National Comprehensive Cancer Network (NCCN) Distress Management Guidelines and the Paykel's Life Events Interview to evaluate the exposure to SLE during the year before the cancer diagnosis. Each patient was genotyped for 5-HTTLPR polymorphism by analyzing genomic DNA obtained from whole blood cells. Gene-Environment interactions were tested through moderation analysis. Results: Twenty-six patients (17.7%) were classified as PTSS cases using the IES. Genotype and phenotype distributions did not differ across individuals with/without PTSS (genotype: χ2 = 1.5; df = 2; p = 0.3; phenotype χ2 = 0.9; df = 1; p = 0.2). For both the genotype and phenotype model, using CRP as a predictor showed significant gene-environment interactions with IES total score (p = 0.020 and p = 0.004, respectively), with individuals carrying the l/l allele showing a greater probability of experiencing PTSS. No interaction was found in relationship to SLE (p = 0.750). Conclusion: This study showed a significant GEI between CRP and PTSS in breast cancer patients, with carriers of the l/l allele showing indicators consistent with greater sensitivity to stress.
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Affiliation(s)
- Luigi Zerbinati
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Martino Belvederi Murri
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Rosangela Caruso
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Maria Giulia Nanni
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Wendy Lam
- Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Silvana Sabato
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Giulia Schillani
- Child Onco-Hematology Unit, Maternal and Child Health, Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS) Burlo Garofolo, Trieste, Italy
| | - Tullio Giraldi
- Section of Pharmacology, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Richard Fielding
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.,Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
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