Boesen Ellen H, Johansen Christoffer
Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
Curr Opin Oncol. 2008 Jul;20(4):372-7. doi: 10.1097/CCO.0b013e3283021690.
The effect of psychotherapy on the survival of cancer patients has been debated for the past 20 years, mainly due to contradictory findings in the studies published so far. Several reviews have been published, almost all of which criticize the methods used in the studies. In 2007, three replication studies were published, which indicate that the hypothesis that psychotherapy prolongs life should be abandoned. The purpose of the present review of randomized studies of psychosocial intervention is to determine the strength of the evidence for enhanced survival after participation in psychosocial interventions.
Three recently published replication studies, which addressed a number of the methodological flaws of earlier studies, did not report better survival among the patients receiving the intervention than among those in the control group.
The hypothesis that psychotherapy enhances survival should be abandoned in the light of the latest replication studies, which show null results for improved survival after psychotherapy. The evidence to date points to a need for investigating the interactions between the medical, psychological, social and health behaviour components of intervention programmes, as recently published studies indicate reduced mortality among patients who engage in physical activity and change to a healthier diet.
在过去20年里,心理治疗对癌症患者生存率的影响一直存在争议,主要原因是迄今发表的研究结果相互矛盾。已经发表了几篇综述,几乎所有综述都批评了这些研究中使用的方法。2007年发表了三项重复研究,这表明心理治疗能延长生命的假设应该被摒弃。本综述对心理社会干预随机研究的目的是确定参与心理社会干预后生存率提高的证据强度。
最近发表的三项重复研究解决了早期研究的一些方法学缺陷,但并未报告接受干预的患者比对照组患者有更好的生存率。
鉴于最新的重复研究表明心理治疗后生存率没有提高,心理治疗能提高生存率的假设应该被摒弃。迄今为止的证据表明,需要研究干预计划中医疗、心理、社会和健康行为成分之间的相互作用,因为最近发表的研究表明,进行体育活动并改为更健康饮食的患者死亡率降低。