Zhihong Li1,2,3, Yanfei Li1,2,3, Liping Guo1,2,3, Meixuan Li1,2,3, Kehu Yang1,2,3. 1. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China. 2. Evidence-based Social Sciences Research Center, School of Public Health, Lanzhou University, Lanzhou, China. 3. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
Abstract
BACKGROUND: Disease awareness is an important aspect of psychological adjustment in cancer patients; however, there is limited evidence that acceptance and commitment therapy (ACT) is recommended for the treatment of mental illness in cancer patients. PURPOSE: To assess the effectiveness of ACT for cancer patients with mental illness. METHODS: Ten databases were searched for publications up to July 25, 2020, using combinations of search terms related to mental health, cancer, and randomised controlled trials (RCTs). Two researchers independently screened the literature, extracted data, and assessed the quality of the study. RESULTS: Seventeen RCTs (877 cancer patients) were mainly of low quality, compared with control group, ACT was associated with improved outcomes after treatment completion and at 1-3 months and at 3-6 months of follow-up for depression (Standardised mean difference [SMD] = -0.93, 95% CI, -1.36 to -0.51, P < .001), anxiety (SMD = -1.22, 95% CI, -2.16 to -0.29, P = .01), quality of life (SMD = 0.85, 95% CI, 0.17 to 1.11, P = .01), psychological distress (SMD = -0.80, 95% CI, -1.24 to 0.35, P < .001), and stress (SMD = -0.54, 95% CI, -1.02 to -0.07, P = .03). After 6 months of follow-up, depression, anxiety, quality of life, and stress were still significant. ACT was associated with psychological flexibility and was not associated with a reduction in fear at treatment completion. However, psychological flexibility (1-3 months) decreased and fear (1-6 months) decreased, and the longer-term effect was still significant. CONCLUSION: ACT can be an important component of future cancer care, as it may alleviate depression, anxiety, stress, and fear, and improve quality of life. However, further research is required to determine long-term treatment effects. High-quality RCTs are needed to more reliably estimate treatment effects.
BACKGROUND: Disease awareness is an important aspect of psychological adjustment in cancerpatients; however, there is limited evidence that acceptance and commitment therapy (ACT) is recommended for the treatment of mental illness in cancerpatients. PURPOSE: To assess the effectiveness of ACT for cancerpatients with mental illness. METHODS: Ten databases were searched for publications up to July 25, 2020, using combinations of search terms related to mental health, cancer, and randomised controlled trials (RCTs). Two researchers independently screened the literature, extracted data, and assessed the quality of the study. RESULTS: Seventeen RCTs (877 cancerpatients) were mainly of low quality, compared with control group, ACT was associated with improved outcomes after treatment completion and at 1-3 months and at 3-6 months of follow-up for depression (Standardised mean difference [SMD] = -0.93, 95% CI, -1.36 to -0.51, P < .001), anxiety (SMD = -1.22, 95% CI, -2.16 to -0.29, P = .01), quality of life (SMD = 0.85, 95% CI, 0.17 to 1.11, P = .01), psychological distress (SMD = -0.80, 95% CI, -1.24 to 0.35, P < .001), and stress (SMD = -0.54, 95% CI, -1.02 to -0.07, P = .03). After 6 months of follow-up, depression, anxiety, quality of life, and stress were still significant. ACT was associated with psychological flexibility and was not associated with a reduction in fear at treatment completion. However, psychological flexibility (1-3 months) decreased and fear (1-6 months) decreased, and the longer-term effect was still significant. CONCLUSION: ACT can be an important component of future cancer care, as it may alleviate depression, anxiety, stress, and fear, and improve quality of life. However, further research is required to determine long-term treatment effects. High-quality RCTs are needed to more reliably estimate treatment effects.
Authors: Kelly E Rentscher; Judith E Carroll; Mark B Juckett; Christopher L Coe; Aimee T Broman; Paul J Rathouz; Peiman Hematti; Erin S Costanzo Journal: J Natl Cancer Inst Date: 2021-10-01 Impact factor: 13.506