The Effectiveness of Cognitive Behaviour Therapy-Based Interventions for Depression in Women with Non-Metastatic Breast Cancer: A Systematic Review and Meta-Analysis

Abstract

Breast cancer is one of the most common types of cancer and the leading cause of cancer-related death in women worldwide. Depressive symptoms, common during non-metastatic breast cancer, can be overlooked and therefore, undertreated. Researchers have previously evaluated the efficacy of Cognitive Behaviour Therapy (CBT) in treating depression in breast cancer patients. However, research investigating the short- and longer-term effectiveness of CBT-based interventions (CBT-BI) in a comprehensive manner is limited, with study quality seldom examined. To address this gap, this meta-analysis searched six electronic databases, identifying six randomised controlled trials (RCT) that examined the effectiveness of CBT-BI for depression in women with non-metastatic breast cancer (Nparticipants = 710). Standardised mean differences between intervention and control groups on self-report depression measures were calculated. Results highlighted that short-term CBT-BI (Hedge’s g = -1.215), particularly individual CBT-BI (Hedge’s g = -1.999), significantly reduced depression in comparison to control groups, while group CBT-BI demonstrated a medium but non-significant effect (Hedge’s g = -.578). CBT-BI also decreased depression levels at three-month follow-up, however, this effect was not maintained at six- and 12-month follow-up. Additionally, quality of included studies was explored in terms of risk of bias, study quality, intervention description, and researcher allegiance, and was found to be of moderate quality. A thorough investigation of CBT-BI, such as conducted in the current research, encourages evidence-based practice by allowing clinicians to more accurately gauge the efficacy of such interventions in treating depression amongst this population, thus, facilitating the development of optimal treatment protocols to improve clinical practices.