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Review
. 2020 Aug:80:101882.
doi: 10.1016/j.cpr.2020.101882. Epub 2020 Jun 25.

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

L M Buffart  1 , M A C Schreurs  2 , H J G Abrahams  3 , J Kalter  4 , N K Aaronson  5 , P B Jacobsen  6 , R U Newton  7 , K S Courneya  8 , J Armes  9 , C Arving  10 , A M Braamse  11 , Y Brandberg  12 , J Dekker  13 , R J Ferguson  14 , M F Gielissen  15 , B Glimelius  16 , M M Goedendorp  17 , K D Graves  18 , S P Heiney  19 , R Horne  20 , M S Hunter  21 , B Johansson  22 , L L Northouse  23 , H S Oldenburg  24 , J B Prins  25 , J Savard  26 , M van Beurden  27 , S W van den Berg  28 , J Brug  29 , H Knoop  30 , I M Verdonck-de Leeuw  31
Affiliations
Review

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

L M Buffart et al. Clin Psychol Rev. 2020 Aug.

Abstract

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.

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Conflict of interest statement

Declaration of Competing Interest None declared.