Effects and moderators of coping skills training on symptoms of depression and anxiety in patients with cancer: Aggregate data and individual patient data meta-analyses

Abstract

© 2020 Elsevier Ltd Purpose: This study evaluated the effects of coping skills training (CST) on symptoms of depression and anxiety in cancer patients, and investigated moderators of the effects. Methods: Overall effects and intervention-related moderators were studied in meta-analyses of pooled aggregate data from 38 randomized controlled trials (RCTs). Patient-related moderators were examined using linear mixed-effect models with interaction tests on pooled individual patient data (n = 1953) from 15 of the RCTs. Results: CST had a statistically significant but small effect on depression (g = −0.31,95% confidence interval (CI) = −0.40;-0.22) and anxiety (g = −0.32,95%CI = -0.41;-0.24) symptoms. Effects on depression symptoms were significantly larger for interventions delivered face-to-face (p =.003), led by a psychologist (p =.02) and targeted to patients with psychological distress (p =.002). Significantly larger reductions in anxiety symptoms were found in younger patients (pinteraction < 0.025), with the largest reductions in patients < 50 years (β = −0.31,95%CI = -0.44;-0.18) and no significant effects in patients ≥ 70 years. Effects of CST on depression (β = −0.16,95%CI = -0.25;-0.07) and anxiety (β = −0.24,95%CI = -0.33;-0.14) symptoms were significant in patients who received chemotherapy but not in patients who did not (pinteraction < 0.05). Conclusions: CST significantly reduced symptoms of depression and anxiety in cancer patients, and particularly when delivered face-to-face, provided by a psychologist, targeted to patients with psychological distress, and given to patients who were younger and received chemotherapy.

Keywords

(individual patient data) meta-analysis, Anxiety, Coping skills training, Depression, Neoplasm, Psychosocial care

Document Type

Journal Article

Date of Publication

8-1-2020

ISSN

02727358

Volume

80

PubMed ID

32640368

Publication Title

Clinical Psychology Review

Publisher

Elsevier

School

Exercise Medicine Research Institute

RAS ID

31949

Funders

A Bas Mulder Award, a personal grant of the Alpe d'HuZes Foundation/Dutch Cancer Society

Comments

Buffart, L. M., Schreurs, M. A. C., Abrahams, H. J. G., Kalter, J., Aaronson, N. K., Jacobsen, P. B., ... & Verdonck-de Leeuw, I. M. (2020). Effects and moderators of coping skills training on symptoms of depression and anxiety in patients with cancer: Aggregate data and individual patient data meta-analyses. Clinical Psychology Review, 80, article 101882. https://doi.org/10.1016/j.cpr.2020.101882

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Link to publisher version (DOI)

10.1016/j.cpr.2020.101882