Assessing the efficacy of cognitive behavioral therapy on anxiety, depression, and distress in people with cancer.

Abstract

12100 Background: Patients with cancer frequently experience psychological impairments, including anxiety, depression, and emotional distress, which may significantly affect quality of life and overall well-being. Third-generation cognitive-behavioral interventions such as Mindfulness-Based Cognitive Therapy-Cancer (MBCT-Ca), Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT) have shown potential benefits in reducing psychological burden, although evidence of their efficacy remains limited. This study aimed to evaluate the efficacy of a structured third-generation cognitive behavioral therapy (CBT) intervention in reducing psychological symptoms in patients (pts) with cancer undergoing active cancer treatment. Methods: A third-generation CBT intervention was delivered twice a month. The eight individual 45-minute sessions included psychoeducation, behavioral activation, relaxation and breathing techniques, present-moment awareness, self-compassion, problem-solving, and assertiveness training. Psychological outcomes were assessed using the Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT) at baseline (T0) and post- psychological intervention (T1). Descriptive statistics, Student t-test and Chi-square test were performed. Results: Overall 341 pts were recruited. The mean age was 65.8 years ( SD = 11.80); 60% (n = 204) were women. Most patients were married or partnered 82% (n = 279). Regarding education level, 65% (n = 221) had higher education, 29% (n = 100) secondary education, and 6% (n = 20) primary education.. At baseline psychological assessment, 4.4% of patients (n = 15) had early-stage disease (stage I–II), 50.7% (n = 173) had locally advanced disease (stage III), and 44.9% (n = 153) had advanced-stage disease (stage IV). The most represented cancer sites were gastrointestinal cancer 55.7% (n = 190), followed by lung 11.7% (n = 41) and breast cancer 10.6% (n = 36). Chemotherapy was the most frequently administrated treatment 74% (n = 254), followed by targeted therapy 10% (n = 35) and immunotherapy 10% (n = 34). At T0, clinically significant levels of anxiety, depression, and distress were reported in 33.2%, 31.3%, and 86,9% of patients, respectively. A total of 313 patients completed the intervention (dropout rate 8.2%, mainly due to disease progression), resulting in an adherence rate of 91.8%. At three-months follow up (T1), significant reductions in clinically relevant symptoms were observed for anxiety (-24.6%, p < 0.001), depression (-24.0%, p < 0.001), and distress (-30.0%, p < 0.001). Conclusions: These findings support the routine use of validated psychological screening tools in oncology and highlight the clinical value of structured CBT-based psycho-oncological interventions delivered by trained professionals to improve psychological well-being in patients with cancer.