Coyne James C, Stefanek Michael, Palmer Steven C
Department of Psychiatry, Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, USA.
Psychol Bull. 2007 May;133(3):367-94. doi: 10.1037/0033-2909.133.3.367.
Despite contradictory findings, the belief that psychotherapy promotes survival in people who have been diagnosed with cancer has persisted since the seminal study by D. Spiegel, J. R. Bloom, H. C. Kramer, and E. Gottheil (1989). The current authors provide a systematic critical review of the relevant literature. In doing so, they introduce some considerations in the design, interpretation of results, and reporting of clinical trials that have not been sufficiently appreciated in the behavioral sciences. They note endemic problems in this literature. No randomized clinical trial designed with survival as a primary endpoint and in which psychotherapy was not confounded with medical care has yielded a positive effect. Among the implications of the review is that an adequately powered study examining effects of psychotherapy on survival after a diagnosis of cancer would require resources that are not justified by the strength of the available evidence.
尽管研究结果相互矛盾，但自D. 斯皮格尔、J. R. 布鲁姆、H. C. 克莱默和E. 戈特西尔于1989年发表开创性研究以来，心理治疗能提高癌症患者生存率这一观点一直存在。本文作者对相关文献进行了系统的批判性综述。在此过程中，他们介绍了一些在行为科学中未得到充分重视的临床试验设计、结果解读及报告方面的考量因素。他们指出了该文献中存在的普遍问题。尚无一项以生存为主要终点且心理治疗未与医疗护理混淆的随机临床试验产生积极效果。该综述的影响之一是，一项有足够效力来检验心理治疗对癌症诊断后生存影响的研究需要的资源，从现有证据的力度来看并不合理。
