Non-pharmacological Therapies for Depression in Women With Breast Cancer at Different Treatment Phases: A Systematic Review and Network Meta-Analysis

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of pain and symptom management Pub Date : 2025-02-01 DOI:10.1016/j.jpainsymman.2024.10.022

Deqi Zhang MD , Wenxin Zhao MD , Lin Yuan MD , Qiling Xu MD , Hongyan Bi MD

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引用次数: 0

Abstract

Context

Various non-pharmacological therapies (NPTs) have been found to be helpful for depression in women with breast cancer (BC). However, the relative efficacy of different NPTs in women with BC during different treatment phases is unclear.

Objectives

To conduct a systematic review and network meta-analysis (NMA) to compare the relative efficacy of various NPTs for improving depression in women with BC during the inter-/post-treatment periods.

Methods

We searched eight databases (Embase, PubMed, PsycINFO, The Cochrane Library, Chinese Biomedical Database, China National Knowledge Infrastructure, Chinese Scientific Journal Database, and WanFang Database) to identify relevant randomized controlled trials published in English and Chinese from their inception to 31 January 2024. We assessed the methodological quality of the included studies using the Cochrane Collaboration Risk of Bias Tool. NMA was conducted using a frequentist approach. The surface under the cumulative ranking (SUCRA) probabilities were used to rank the NPTs.

Results

A total of 41 articles involving 5408 participants studied 18 NPTs. Based on NMA, in the intertreatment phase, mindfulness-based cognitive therapy (MBCT), psychological education, virtual reality (VR) and yoga significantly improved depression in women with BC. MBCT, psychological education, and VR were the three most effective NPTs in this period. In the post-treatment phase, mindfulness-based stress reduction significantly improved depression in women with BC, which was the most effective NPTs in this period. Based on the GRADE framework, most results were rated as “high” to “very low” for the confidence of evidence.

Conclusions

Our study confirmed the efficacy of several NPTs for depression in women with BC during inter-/post-treatment phases. These results should inform future clinical decisions and guidelines for depression in women with BC.

查看原文本刊更多论文

不同治疗阶段乳腺癌妇女抑郁症的非药物疗法：系统综述和网络荟萃分析。

背景：研究发现，各种非药物疗法（NPTs）有助于治疗乳腺癌（BC）女性患者的抑郁症。然而，不同的非药物疗法在不同治疗阶段对乳腺癌女性患者的相对疗效尚不明确：目的：进行一项系统性综述和网络荟萃分析（NMA），比较各种 NPTs 在治疗间期/治疗后阶段对改善 BC 女性患者抑郁状况的相对疗效：我们检索了 8 个数据库（Embase、PubMed、PsycINFO、The Cochrane Library、中国生物医学数据库、中国国家知识基础设施、中文科技期刊数据库和万方数据库），以确定从开始到 2024 年 1 月 31 日发表的相关中英文随机对照试验。我们使用 Cochrane 协作偏倚风险工具评估了纳入研究的方法学质量。采用频数主义方法进行 NMA。采用累积排序（SUCRA）概率表面对 NPT 进行排序：共有 41 篇文章（涉及 5408 名参与者）研究了 18 种 NPTs。根据 NMA，在治疗间歇阶段，正念认知疗法（MBCT）、心理教育、虚拟现实（VR）和瑜伽能显著改善 BC 女性患者的抑郁状况。在这一阶段，正念认知疗法、心理教育和虚拟现实是三种最有效的 NPT。在治疗后阶段，正念减压疗法明显改善了女性 BC 患者的抑郁状况，是这一阶段最有效的 NPTs。根据 GRADE 框架，大多数结果的证据可信度被评为 "高 "至 "很低"：我们的研究证实了几种 NPTs 在治疗间期/治疗后阶段对 BC 妇女抑郁症的疗效。这些结果应为今后针对女性 BC 患者抑郁症的临床决策和指南提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pain and symptom management 医学-临床神经学

CiteScore

8.90

自引率

6.40%

发文量

821

审稿时长

26 days

期刊介绍： The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.