Effects of cognitive behavioral therapy for depression on improving insomnia and quality of life in Chinese women with breast cancer: results of a randomized, controlled, multicenter trial
Received 16 April 2018
Accepted for publication 24 July 2018
Published 10 October 2018 Volume 2018:14 Pages 2665—2673
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Justinn Cochran
Peer reviewer comments 2
Editor who approved publication: Dr Yuping Ning
Huihua Qiu,1 Wenwei Ren,1 Yanjie Yang,2 Xiongzhao Zhu,3 Guangyun Mao,4 Shanping Mao,5 Yan Lin,6 Shanshan Shen,7 Changjin Li,8 Hongying Shi,4 Suo Jiang,8 Jingjing He,9 Ke Zhao,8 Ye Fu,10 Xiaoqu Hu,11 Yingying Gu,1 Kai Wang,12 Xiuchan Guo,13 Jincai He1,8
1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 2Department of Medical Psychology, Public Health Institute of Harbin Medical University, Harbin, People’s Republic of China; 3Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 4Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, People’s Republic of China; 5Department of Neurology, RenMin Hospital of Wuhan University, Wuhan, People’s Republic of China; 6Department of Neurology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 7Department of Geriatrics, Zhejiang Hospital, Hangzhou, People’s Republic of China; 8Department of Psychology, Wenzhou Medical University, Wenzhou, People’s Republic of China; 9Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, People’s Republic of China; 10Yinzhou Hospital Affiliated To Medical School of Ningbo University, Ningbo, People’s Republic of China; 11Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 12Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 13Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People’s Republic of China
Purpose: 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.
Patients and methods: 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.
Results: There was a significant intergroup difference in AIS and FACT-B scores (both P<0.01). CBT showed less insomnia problems and better overall QOL compared with those in SCM and UC (both P<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.
Conclusion: CBT for depression can be effective in improving insomnia problems and QOL in the Chinese breast cancer survivors.
Keywords: cancer, psychotherapy, sleep, prognosis
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