5503 - Impact of Cognitive-Behavioral-Therapy (CBT) on levels of anxiety, depression and distress in cancer patients (pts)

Background

Oncological pts usually experience symptoms that include anxiety, depression and distress. The aim of this preliminary study was to explore the effect of Cognitive-Behavioral-Therapy (CBT) in cancer pts.

Methods

An open trial evaluated the treatment effects of CBT in breast and lung pts referring to a clinical psychology health service specialized in psycho-oncology. Levels of anxiety and depression were assessed using the validated self-report questionnaires Hospital Anxiety and Depression Scale (HADS), while the distress was evaluated with the Distress Thermometer (DT). The statistical analysis includes the Wilcoxon-Mann-Whitney and the Spearman rank tests.

Results

At a median follow-up of 6 months, data from 43 pts (88% breast and 12% lung cancer) were prospectively collected (median age: 49 years). At baseline, 62.8% and 44.2% of pts were borderline abnormal for anxiety and depression, while 34.9% and 30.2% reported abnormal levels. All pts presented high levels of distress. A significant correlation between anxiety and depression was observed (r_s=0.55; p < 0.01), as well as distress (r_s=0.78; p < 0.01) and baseline body mass index (BMI) (r_s=0.41; p < 0.01). Moreover, depression was associated with distress (r_s=0.70; p < 0.01), age (r_s=0.30; p = 0.05) and time from diagnosis (r_s=0.30; p = 0.04). Six months after the CTB, only 7% and 5% of pts had abnormal levels of anxiety and depression, while borderline abnormal values were observed in 58% and 40% of pts, respectively. Furthermore, after CTB the levels of anxiety (p < 0.001), depression (p < 0.001) and distress (p < 0.001) were significantly lower than baseline. Of interest, a sub-analysis among breast cancer pts showed that baseline BMI was related to anxiety (r_s=0.49; p = 0.002) and distress (r_s=0.37, p = 0.02). Physical activity level was inversely associated with anxiety (r_s=-0.41; p = 0.01), depression (r_s=-0.49; p = 0.002) and distress (r_s=-0.40; p = 0.01).

Conclusions

These results highlight the importance of the introduction in clinical routine of validated psychological screening for anxiety, depression and distress as well as psychological intervention, carried out by trained psycho-oncology.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

University of Verona.

Funding

Has not received any funding.

Disclosure

E. Bria: Honoraria (self): MSD, AstraZeneca, Celgene, Pfizer, Helsinn, Eli Lilly, BMS, Novartis, and Roche. ; Research grant / Funding (self): AIRC-IG 20583. M. Milella: Honoraria (self): Pfizer, EUSA Pharma, AstraZeneca. S. Pilotto: Honoraria (self): AstraZeneca, Eli Lilly, BMS, Boehringer Ingelheim, Roche, MSD and Istituto Gentili. ; Research grant / Funding (self): AIRC-IG 20583. All other authors have declared no conflicts of interest.