TABLE B-2 Randomized Trials in “Metastatic” Breast Cancer

Citation

n

Intervention(s)

Duration

Outcomes

Spiegel

1981

1983

1989

86

Supportive–expressive group therapy vs. control

Weekly x 90 minutes

x ≥ 1 year

• Intervention improved mood, reduced maladaptive coping responses and phobias.

• Intervention prolonged survival (mean 36.6 vs. 18.9 months intervention vs. control).

(psychological follow-up x 12 months, survival > 10 years)

Arathuzik

1994

24

Individual structured relaxation and visualization with or without cognitive–behavioral therapy vs. written handouts about pain distraction

1 x 75 minutes

(relaxation and imagery alone)

• No effects of intervention.

(same day follow-up)

Edelman

1999

121

Group cognitive–behavioral therapy vs. control

Weekly x 8, monthly x 3,

one family session (each 2 hours)

• Intervention improved mood and reduced depression, enhanced self-esteem.

• Effects present at end of intervention but not 3 or 6 months later.

• No effect on survival.

(follow-up 12 months for psychological outcomes, 2 to 5 years for survival)

Edmonds

1999

Cunningham

1999

66

Supportive plus cognitive–behavioral group therapy vs. home cognitive–behavioral study program

Weekly x 2 hours

x 35 weeks (longer in some women)

plus one weekend

• Intervention subjects experienced more anxious-preoccupied coping and less helplessness coping.

• No survival effects.

(psychological follow-up x 12 months, survival to > 5 years)



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