Chong Guan Ng, Mohamed Salina, Kian Tiah Lai, Kar Mun Teoh, Sulaiman Ahmad Hatim, Zainal Nor Zuraida
1 Department of Psychological Medicine, University Malaya Medical Centre, Malaysia.
2 Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Malaysia.
Int J Psychiatry Med. 2016 Jul;51(5):414-430. doi: 10.1177/0091217416680197.
Objective Psychotherapy is a common non-pharmacological approach to help cancer patients in their psychological distress. The benefit of psychotherapies was documented, but the types of psychotherapies proposed are varied. Given that the previous literature review was a decade ago and no quantitative analysis was done on this topic, we again critically and systematically reviewed all published trials on psychotherapy in cancer patients. Method We identified 17 clinical trials on six types of psychotherapy for cancer patients by searching PubMed and EMBASE. Result There were four trials involved adjunct psychological therapy which were included in quantitative analysis. Each trial demonstrated that psychotherapy improved the quality of life and coping in cancer patients. There was also a reduction in distress, anxiety, and depression after a psychological intervention. However, the number and quality of clinical trials for each type of psychotherapy were poor. The meta-analysis of the four trials involved adjunct psychological therapy showed no significant change in depression, with only significant short-term improvement in anxiety but not up to a year-the standardized mean differences were -0.37 (95% confidence interval (CI) = -0.57, -0.16) at 2 months, -0.21 (95% CI = -0.42, -0.01) at 4 months, and 0.03 (95 % CI = -0.19, 0.24) at 12 months. Conclusion The evidence on the efficacy of psychotherapy in cancer patients is unsatisfactory. There is a need for more rigorous and well-designed clinical trials on this topic.
目的 心理治疗是帮助癌症患者缓解心理痛苦的一种常见非药物治疗方法。心理治疗的益处已有文献记载,但所提出的心理治疗类型多种多样。鉴于此前的文献综述是在十年前进行的,且未对该主题进行定量分析,我们再次对所有已发表的关于癌症患者心理治疗的试验进行了严格且系统的综述。方法 通过检索PubMed和EMBASE,我们确定了17项针对癌症患者的六种心理治疗类型的临床试验。结果 有四项涉及辅助心理治疗的试验被纳入定量分析。每项试验均表明,心理治疗可改善癌症患者的生活质量和应对能力。心理干预后,痛苦、焦虑和抑郁也有所减轻。然而,每种心理治疗类型的临床试验数量和质量都很差。对四项涉及辅助心理治疗的试验进行的荟萃分析显示,抑郁无显著变化,仅焦虑有显著短期改善,但未持续至一年——在2个月时标准化均差为-0.37(95%置信区间(CI)=-0.57,-0.16),4个月时为-0.21(95%CI=-0.42,-0.01),12个月时为0.03(95%CI=-0.19,0.24)。结论 关于心理治疗对癌症患者疗效的证据并不令人满意。需要针对该主题开展更严格、设计更完善的临床试验。