A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression

Abstract

Background: This study aims to evaluate the effects of Group Cognitive Behavioral Therapy (GCBT) in treating major depression in Chinese women with breast cancer.

Methods: Sixty-two breast cancer patients diagnosed with major depression were randomly assigned to GCBT group (N = 31) or a waiting list control group provided with an educational booklet (N = 31). The primary outcome measure was the 17-Item Hamilton Depression Rating Scale (17-HAMD). The second outcome measures were Self-Rating Anxiety Scale, Functional Assessment of Cancer Therapy – Breast and Self-Esteem Scale (SES). Assessments were carried out at completion of the study and six-month afterwards.

Results: Patients in the GCBT group had a significant reduction in the 17-HAMD mean score by 9 points (p < 0.001), more than any reduction among patients in the control group from baseline to the end of therapy and a significant 7 points (p < 0.001) more reduction from baseline to six-month follow-up. GCBT also yielded significantly greater improvement than the control group with regard to quality of life (QoL; p < 0.01) and self-esteem (p < 0.05). No significant differences were found between groups on improving anxiety (p > 0.05).

Conclusion: The results of this trial suggest that GCBT is effective for treating major depression, as well as for improving QoL and self-esteem in breast cancer patients.

Trial Registration: Chictr.org ChiCTR-TRC-11001689

• Breast cancer
• group cognitive behavioral therapy
• major depression

Acknowledgements

The authors thank Prof. Chunbo Li, Ms Stephanie Sampson and Prof. Justine Schneider for their comments. They are grateful to the program of Nottingham Institute of Mental Health Exchange Fellowship.

Current knowledge on this subject

• The co-morbidity of depression in breast cancer patients is very common. Some studies have showed that GCBT approach was particularly beneficial to the depressed women with breast cancer. But it is unclear whether GCBT could be an equally effective treatment for major depression in Chinese breast cancer women.

What this study adds

• In this study we will evaluate the effects of GCBT for major depression in Chinese breast cancer patients in a rigorous analysis. The results of this trial suggest that GCBT is effective for treating major depression. The study also highlights the importance for integrating psychological care into the cancer service, and particularly, GCBT as a promising treatment.