Qiu Huihua, Ren Wenwei, Yang Yanjie, Zhu Xiongzhao, Mao Guangyun, Mao Shanping, Lin Yan, Shen Shanshan, Li Changjin, Shi Hongying, Jiang Suo, He Jingjing, Zhao Ke, Fu Ye, Hu Xiaoqu, Gu Yingying, Wang Kai, Guo Xiuchan, He Jincai
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China,
Department of Medical Psychology, Public Health Institute of Harbin Medical University, Harbin, People's Republic of China.
Neuropsychiatr Dis Treat. 2018 Oct 10;14:2665-2673. doi: 10.2147/NDT.S171297. eCollection 2018.
Cognitive behavioral therapy (CBT) for depression had been found to be effective in reducing depressive and anxiety symptoms in breast cancer survivors. It is not known whether CBT for depression would also improve insomnia and quality of life (QOL). The aim of this study was to investigate whether CBT for depression would improve insomnia and QOL in a randomized controlled multicenter trial.
In this study, breast cancer survivors (n=392) were randomly allocated to the following three groups: CBT (n=98), self-care management (SCM, n=98), and usual care (UC, n=196) in a ratio of 1:1:2. CBT and SCM received a series of nine sessions for 12 weeks, whereas UC received UC only. Insomnia and QOL were evaluated using Athens Insomnia Scale (AIS) and Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire at baseline, 4, 12, and 24 weeks.
There was a significant intergroup difference in AIS and FACT-B scores (both <0.01). CBT showed less insomnia problems and better overall QOL compared with those in SCM and UC (both <0.01). No significant differences were found between SCM and UC in insomnia problems and overall QOL. Moreover, the effects of CBT on insomnia and QOL were maintained during the follow-up period.
CBT for depression can be effective in improving insomnia problems and QOL in the Chinese breast cancer survivors.
已发现针对抑郁症的认知行为疗法(CBT)在减轻乳腺癌幸存者的抑郁和焦虑症状方面有效。尚不清楚针对抑郁症的CBT是否也能改善失眠和生活质量(QOL)。本研究的目的是在一项随机对照多中心试验中调查针对抑郁症的CBT是否能改善失眠和QOL。
在本研究中,乳腺癌幸存者(n = 392)被随机分为以下三组:CBT组(n = 98)、自我护理管理组(SCM,n = 98)和常规护理组(UC,n = 196),比例为1:1:2。CBT组和SCM组接受为期12周的一系列九次治疗,而UC组仅接受常规护理。在基线、第4、12和24周时,使用雅典失眠量表(AIS)和癌症治疗功能评估-乳腺癌(FACT-B)问卷评估失眠和QOL。
AIS和FACT-B评分存在显著的组间差异(均<0.01)。与SCM组和UC组相比,CBT组的失眠问题更少,总体QOL更好(均<0.01)。SCM组和UC组在失眠问题和总体QOL方面未发现显著差异。此外,CBT对失眠和QOL的影响在随访期间得以维持。
针对抑郁症的CBT对改善中国乳腺癌幸存者的失眠问题和QOL有效。