Charles S. Carver

Stagl, J. M., Bouchard, L. C., Lechner, S. C., Blomberg, B. B., Gudenkauf, L. M., Jutagir, D. R., Glück, S., Derhagopian, R. P., Carver, C. S., & Antoni, M. H. (2015). Long term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial. Cancer, 121, 1873-1881.

BACKGROUND: Breast cancer survivors experience long-term side effects following primary treatment that negatively influence quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered post-surgery for early stage breast cancer was previously associated with better QOL over a 12-month follow-up, as well as with fewer depressive symptoms up to five years post-study enrollment. This 8-15 year (11-year median) follow-up of a previously conducted trial (#NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at the 8-15 years follow-up.

METHODS: Women with stage 0-IIIb breast cancer were initially recruited 2-10 weeks post-surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM, 49 controls) were re-contacted 8-15 years post study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies- Depression scale (CES-D) and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D and FACT-B over and above effects of confounding variables.

RESULTS: Participants assigned to CBSM reported significantly lower depressive symptoms (d=0.63, 95% CI [0.56,0.70]), and better QOL (d=0.58, 95% CI [0.52,0.65]), above the effects of the covariates.

CONCLUSIONS: Women who received CBSM post-surgery for early stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.

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