The Effectiveness of Cognitive Behavioral Therapy on Depression and Anxiety Symptoms in Breast Cancer Patients and Survivors: A Systematic Review of Interventional Studies

Abstract

Introduction

Breast cancer (BC) is the most common type of cancer and the second cause of cancer-related death among women. Psychological treatments such as cognitive behavioral therapy (CBT) have been used as an effective method in the treatment of depression and anxiety in BC patients, and their effectiveness has been approved in various studies.

Objective

The present study aimed to systematically investigate the effectiveness of CBT on depression and anxiety symptoms in BC patients and survivors.

Methods

Electronic databases such as PubMed, Scopus, Web of Science [WOS], ScienceDirect, Cochrane Library, and Google Scholar were systematically searched from “October 2023” to “February 2024.” The quality of the included studies was evaluated using the Critical Appraisal Skills Programme (CASP). In this study, the randomized controlled trials and quasi-experimental studies that assessed the effectiveness of CBT, cognitive behavioral group therapy (CBGT), and the combination of CBT with other psychological studies on depression and anxiety of BC patients and survivors were reviewed.

Results

Out of the 16 included studies, six used CBT, and six used CBGT. In the other four studies, a combination of CBT with other psychological interventions was implemented as an interventional program. Among 16 included studies, 14 studies showed that CBT, CBGT, and a combination of CBT with other psychological interventions significantly decreased the anxiety and depression scores among BC patients and survivors (p < 0.05), and only in two studies, no significant effect was observed.

Conclusion

As most included studies showed the effectiveness of CBT in decreasing the depression and anxiety scores among BC patients and survivors, this study strongly suggests CBT as an effective non-pharmacological method for the treatment of psychiatric disorders of BC patients during cancer treatments and also for BC survivors.