Classen C, Butler L D, Koopman C, Miller E, DiMiceli S, Giese-Davis J, Fobair P, Carlson R W, Kraemer H C, Spiegel D
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94131-5718, USA.
Arch Gen Psychiatry. 2001 May;58(5):494-501. doi: 10.1001/archpsyc.58.5.494.
Metastatic breast cancer carries with it considerable psychosocial morbidity. Studies have shown that some patients with metastatic breast cancer experience clinically significant anxiety and depression and traumatic stress symptoms. Supportive-expressive group psychotherapy was developed to help patients with cancer face and adjust to their existential concerns, express and manage disease-related emotions, increase social support, enhance relationships with family and physicians, and improve symptom control.
Of 125 women with metastatic breast cancer recruited into the study, 64 were randomized to the intervention and 61 to the control condition. Intervention women were offered 1 year of weekly supportive-expressive group therapy and educational materials. Control women received educational materials only. Participants were assessed at baseline and every 4 months during the first year. Data at baseline and from at least 1 assessment were collected from 102 participants during this 12-month period, and these participants compose the study population.
Primary analyses based on all available data indicated that participants in the treatment condition showed a significantly greater decline in traumatic stress symptoms on the Impact of Event Scale (effect size, 0.25) compared with the control condition, but there was no difference in Profile of Mood States total mood disturbance. However, when the final assessment occurring within a year of death was removed, a secondary analysis showed a significantly greater decline in total mood disturbance (effect size, 0.25) and traumatic stress symptoms (effect size, 0.33) for the treatment condition compared with the control condition.
Supportive-expressive therapy, with its emphasis on providing support and helping patients face and deal with their disease-related stress, can help reduce distress in patients with metastatic breast cancer.
转移性乳腺癌会带来相当大的心理社会问题。研究表明，一些转移性乳腺癌患者会出现临床上显著的焦虑、抑郁和创伤后应激症状。支持性表达团体心理治疗旨在帮助癌症患者面对并适应其生存问题，表达和管理与疾病相关的情绪，增加社会支持，改善与家人和医生的关系，并更好地控制症状。
在招募进入该研究的125名转移性乳腺癌女性患者中，64名被随机分配至干预组，61名被分配至对照组。干预组女性接受为期1年的每周一次的支持性表达团体治疗及教育材料。对照组女性仅接受教育材料。在基线期及第一年中每4个月对参与者进行评估。在这12个月期间，从102名参与者处收集了基线期数据及至少一次评估的数据，这些参与者构成了研究人群。
基于所有可用数据的初步分析表明，与对照组相比，治疗组参与者在事件影响量表上的创伤后应激症状有显著更大程度的下降（效应量为0.25），但在情绪状态剖面图总情绪困扰方面没有差异。然而，当去除在死亡前一年内进行的最后一次评估后，二次分析显示，与对照组相比，治疗组在总情绪困扰（效应量为0.25）和创伤后应激症状（效应量为0.33）方面有显著更大程度的下降。
支持性表达疗法强调提供支持并帮助患者面对和应对与疾病相关的压力，有助于减轻转移性乳腺癌患者的痛苦。
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