Efficacy of Cognitive Behavioral Therapy and Physical Exercise in Alleviating Treatment-Induced Menopausal Symptoms in Patients With Breast Cancer: Results of a Randomized, Controlled, Multicenter Trial

2012 ◽  
Vol 30 (33) ◽  
pp. 4124-4133 ◽  
Author(s):  
Saskia F.A. Duijts ◽  
Marc van Beurden ◽  
Hester S.A. Oldenburg ◽  
Myra S. Hunter ◽  
Jacobien M. Kieffer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Exercise ◽  
Cognitive Behavioral Therapy ◽  
Physical Functioning ◽  
Effect Size ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Menopausal Symptoms ◽  
Control Group ◽  
Endocrine Symptoms

Purpose The purpose of our study was to evaluate the effect of cognitive behavioral therapy (CBT), physical exercise (PE), and of these two interventions combined (CBT/PE) on menopausal symptoms (primary outcome), body image, sexual functioning, psychological well-being, and health-related quality of life (secondary outcomes) in patients with breast cancer experiencing treatment-induced menopause. Patients and Methods Patients with breast cancer reporting treatment-induced menopausal symptoms (N = 422) were randomly assigned to CBT (n = 109), PE (n = 104), CBT/PE (n = 106), or to a waiting list control group (n = 103). Self-report questionnaires were completed at baseline, 12 weeks, and 6 months. Multilevel procedures were used to compare the intervention groups with the control group over time. Results Compared with the control group, the intervention groups had a significant decrease in levels of endocrine symptoms (Functional Assessment of Cancer Therapy–Endocrine Symptoms; P < .001; effect size, 0.31-0.52) and urinary symptoms (Bristol Female Lower Urinary Tract Symptoms Questionnaire; P = .002; effect size, 0.29-0.33), and they showed an improvement in physical functioning (36-Item Short Form Health Survey physical functioning subscale; P = .002; effect size, 0.37-0.46). The groups that included CBT also showed a significant decrease in the perceived burden of hot flashes and night sweats (problem rating scale of the Hot Flush Rating Scale; P < .001; effect size, 0.39-0.56) and an increase in sexual activity (Sexual Activity Questionnaire habit subscale; P = .027; effect size, 0.65). Most of these effects were observed at both the 12-week and 6-month follow-ups. Conclusion CBT and PE can have salutary effects on endocrine symptoms and, to a lesser degree, on sexuality and physical functioning of patients with breast cancer experiencing treatment-induced menopause. Future work is needed to improve the design and the planning of these interventions to improve program adherence.

scholarly journals Randomized Controlled Trial of a Cognitive-Behavioral Therapy Plus Hypnosis Intervention to Control Fatigue in Patients Undergoing Radiotherapy for Breast Cancer

2014 ◽  
Vol 32 (6) ◽  
pp. 557-563 ◽  
Author(s):  
Guy H. Montgomery ◽  
Daniel David ◽  
Maria Kangas ◽  
Sheryl Green ◽  
Madalina Sucala ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Behavioral Therapy ◽  
Muscle Weakness ◽  
Behavioral Therapy ◽  
Attention Control ◽  
Cognitive Behavioral ◽  
Control Group ◽  
End Of Treatment ◽  
Vas Scores

Purpose The objective of this study was to test the efficacy of cognitive-behavioral therapy plus hypnosis (CBTH) to control fatigue in patients with breast cancer undergoing radiotherapy. We hypothesized that patients in the CBTH group receiving radiotherapy would have lower levels of fatigue than patients in an attention control group. Patients and Methods Patients (n = 200) were randomly assigned to either the CBTH (n = 100; mean age, 55.59 years) or attention control (n = 100; mean age, 55.97 years) group. Fatigue was measured at four time points (baseline, end of radiotherapy, 4 weeks, and 6 months after radiotherapy). Fatigue was measured using the Functional Assessment of Chronic Illness Therapy (FACIT) –Fatigue subscale and Visual Analog Scales (VASs; Fatigue and Muscle Weakness). Results The CBTH group had significantly lower levels of fatigue (FACIT) at the end of radiotherapy (z, 6.73; P < .001), 4-week follow-up (z, 6.98; P < .001), and 6-month follow-up (z, 7.99; P < .001) assessments. Fatigue VAS scores were significantly lower in the CBTH group at the end of treatment (z, 5.81; P < .001) and at the 6-month follow-up (z, 4.56; P < .001), but not at the 4-week follow-up (P < .07). Muscle Weakness VAS scores were significantly lower in the CBTH group at the end of treatment (z, 9.30; P < .001) and at the 6-month follow-up (z, 3.10; P < .02), but not at the 4-week follow-up (P < .13). Conclusion The results support CBTH as an evidence-based intervention to control fatigue in patients undergoing radiotherapy for breast cancer. CBTH is noninvasive, has no adverse effects, and its beneficial effects persist long after the last intervention session. CBTH seems to be a candidate for future dissemination and implementation.

scholarly journals Efficacy of Sertraline Combined with Cognitive Behavioral Therapy for Adolescent Depression: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wenliang Liu ◽  
Gongying Li ◽  
Congjie Wang ◽  
Xiuzhen Wang ◽  
Lin Yang
Keyword(s):  
Combination Therapy ◽  
Cognitive Behavioral Therapy ◽  
Scale Score ◽  
Adolescent Depression ◽  
Adverse Reactions ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Depression Score ◽  
Control Group

Objective. The efficacy of antidepressant drugs combined with psychotherapy is controversial; hence, this meta-analysis was conducted to assess the efficacy of the combination therapy. Methods. Relevant literature was searched in PubMed, Web of Science and Embase, Chinese databases CNKI, and WanFang Data. We included the literature on the comparison of the sertraline combined with cognitive behavioral therapy (CBT) and each treatment alone for adolescent depression published in 2000-2021. Meta-analysis was performed using Stata16.0 software. Results. A total of 421 relevant articles were retrieved, and 14 studies were finally included. In comparison with the control group (sertraline), sertraline combined with CBT achieved higher response rate ( OR = 5.07 , 95% CI: 3.00, 8.58) and lower incidence of adverse reactions ( OR = 0.43 , 95% CI: 0.24, 0.75). Before treatment, there were no significant differences in depression score, anxiety score, and symptom self-rating scale score between the two groups. After treatment, depression score ( SMD = − 2.79 , 95% CI: -3.64, -1.94), anxiety score ( SMD = − 1.22 , 95% CI: -1.96, -0.47), and symptom self-rating scale score ( SMD = − 1.73 , 95% CI: -3.19, -0.27) were significantly lower in the combined treatment group than in the control group. Conclusion. Although the number of comparative trials is small, this study shows that sertraline is effective for adolescent depression, but sertraline combined with CBT is more effective. The latter can significantly reduce the incidence of depressive symptoms, anxiety, and adverse reactions in patients. Therefore, this combination therapy is recommended for the clinical treatment of adolescent depression.

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