L M Buffart1, M A C Schreurs2, H J G Abrahams3, J Kalter4, N K Aaronson5, P B Jacobsen6, R U Newton7, K S Courneya8, J Armes9, C Arving10, A M Braamse11, Y Brandberg12, J Dekker13, R J Ferguson14, M F Gielissen15, B Glimelius16, M M Goedendorp17, K D Graves18, S P Heiney19, R Horne20, M S Hunter21, B Johansson22, L L Northouse23, H S Oldenburg24, J B Prins25, J Savard26, M van Beurden27, S W van den Berg28, J Brug29, H Knoop30, I M Verdonck-de Leeuw31. 1. Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands; Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia. Electronic address: laurien.buffart@radboudumc.nl. 2. Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. Electronic address: m.a.c.schreurs@erasmusmc.nl. 3. Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: harriet_abrahams@hotmail.com. 4. Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands. Electronic address: joeri.kalter@wur.nl. 5. Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands. Electronic address: n.aaronson@nki.nl. 6. Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, MD, Florida, USA. Electronic address: jacobsen.phd@gmail.com. 7. Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia. Electronic address: r.newton@ecu.edu.au. 8. Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada. Electronic address: kerry.courneya@ualberta.ca. 9. School of Health Science, University of Surrey, Surrey, UK. Electronic address: jo.armes@surrey.ac.uk. 10. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Electronic address: cecilia.arving@pubcare.uu.se. 11. Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: a.m.braamse@amsterdamumc.nl. 12. Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. Electronic address: yvonne.brandberg@ki.se. 13. Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. Electronic address: J.Dekker@amsterdamumc.nl. 14. Division of Hematology-Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA. Electronic address: fergusonrj2@upmc.edu. 15. Academy Het Dorp/ Siza, Arnhem, the Netherlands. Electronic address: marieke.gielissen@siza.nl. 16. Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. Electronic address: bengt.glimelius@igp.uu.se. 17. Department of Health Science, Faculty of Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: m.m.goedendorp@vu.nl. 18. Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA. Electronic address: kristi.graves@georgetown.edu. 19. College of Nursing, University of South Carolina, Columbia, SC, USA. Electronic address: heineys@mailbox.sc.edu. 20. UCL School of Pharmacy, University College London, London, UK. Electronic address: rob.horne@pharmacy.ac.uk. 21. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Electronic address: myra.hunter@kcl.ac.uk. 22. Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. Electronic address: birgitta.johansson@igp.uu.se. 23. University of Michigan School of Nursing, Ann Arbor, MI, USA. Electronic address: lnortho@umich.edu. 24. Department of Surgical Oncology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands. Electronic address: h.oldenburg@nki.nl. 25. Department of Medical Psychology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, the Netherlands. Electronic address: judith.prins@radboudumc.nl. 26. School of Psychology, Université Laval and Laval University Cancer Research Center, Québec, QC, Canada. Electronic address: Josee.Savard@psy.ulaval.ca. 27. Department of Gynecology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands. Electronic address: m.v.beurden@nki.nl. 28. Department of Medical Psychology, Radboud University Medical Center, Radboud Institute of Health Sciences, Nijmegen, the Netherlands. Electronic address: sw_vandenberg@yahoo.com. 29. National Institute of Public Health and the Environment, Bilthoven, the Netherlands. Electronic address: Johannes.brug@rivm.nl. 30. Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: hans.knoop@amsterdamumc.nl. 31. Department of Otolaryngology-Head and Neck Surgery and Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, the Netherlands. Electronic address: im.verdonck@amsterdamumc.nl.
Abstract
PURPOSE: This study evaluated the effects of coping skills training (CST) on symptoms of depression and anxiety in cancer patients, and investigated moderators of the effects. METHODS: Overall effects and intervention-related moderators were studied in meta-analyses of pooled aggregate data from 38 randomized controlled trials (RCTs). Patient-related moderators were examined using linear mixed-effect models with interaction tests on pooled individual patient data (n = 1953) from 15 of the RCTs. RESULTS: CST had a statistically significant but small effect on depression (g = -0.31,95% confidence interval (CI) = -0.40;-0.22) and anxiety (g = -0.32,95%CI = -0.41;-0.24) symptoms. Effects on depression symptoms were significantly larger for interventions delivered face-to-face (p = .003), led by a psychologist (p = .02) and targeted to patients with psychological distress (p = .002). Significantly larger reductions in anxiety symptoms were found in younger patients (pinteraction < 0.025), with the largest reductions in patients <50 years (β = -0.31,95%CI = -0.44;-0.18) and no significant effects in patients ≥70 years. Effects of CST on depression (β = -0.16,95%CI = -0.25;-0.07) and anxiety (β = -0.24,95%CI = -0.33;-0.14) symptoms were significant in patients who received chemotherapy but not in patients who did not (pinteraction < 0.05). CONCLUSIONS: CST significantly reduced symptoms of depression and anxiety in cancer patients, and particularly when delivered face-to-face, provided by a psychologist, targeted to patients with psychological distress, and given to patients who were younger and received chemotherapy.
PURPOSE: This study evaluated the effects of coping skills training (CST) on symptoms of depression and anxiety in cancerpatients, and investigated moderators of the effects. METHODS: Overall effects and intervention-related moderators were studied in meta-analyses of pooled aggregate data from 38 randomized controlled trials (RCTs). Patient-related moderators were examined using linear mixed-effect models with interaction tests on pooled individual patient data (n = 1953) from 15 of the RCTs. RESULTS: CST had a statistically significant but small effect on depression (g = -0.31,95% confidence interval (CI) = -0.40;-0.22) and anxiety (g = -0.32,95%CI = -0.41;-0.24) symptoms. Effects on depression symptoms were significantly larger for interventions delivered face-to-face (p = .003), led by a psychologist (p = .02) and targeted to patients with psychological distress (p = .002). Significantly larger reductions in anxiety symptoms were found in younger patients (pinteraction < 0.025), with the largest reductions in patients <50 years (β = -0.31,95%CI = -0.44;-0.18) and no significant effects in patients ≥70 years. Effects of CST on depression (β = -0.16,95%CI = -0.25;-0.07) and anxiety (β = -0.24,95%CI = -0.33;-0.14) symptoms were significant in patients who received chemotherapy but not in patients who did not (pinteraction < 0.05). CONCLUSIONS: CST significantly reduced symptoms of depression and anxiety in cancerpatients, and particularly when delivered face-to-face, provided by a psychologist, targeted to patients with psychological distress, and given to patients who were younger and received chemotherapy.
Authors: M G E Verdam; W van Ballegooijen; C J M Holtmaat; H Knoop; J Lancee; F J Oort; H Riper; A van Straten; I M Verdonck-de Leeuw; M de Wit; T van der Zweerde; M A G Sprangers Journal: PLoS One Date: 2021-05-25 Impact factor: 3.240