title: Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review.
abstract: OBJECTIVE
  This systematic review aimed to determine the effectiveness of psychoeducation, cognitive behavioural therapy (CBT) and social support interventions used in the rehabilitation of breast cancer (BC) patients.
  
  
  METHODS
  We conducted a systematic literature search to identify randomised controlled trials of female BC patients who underwent different psychosocial interventions during or after primary cancer treatment. The methodological quality of all studies was independently assessed by two reviewers. Studies with low quality, less than 20 participants in each group, patients with metastatic cancer, data not presented separately for BC and studies that included other cancer types were excluded.
  
  
  RESULTS
  Among 9617 identified studies, only 18 RCTs published between 1999 and 2008, including 3272 patients were finally included in this systematic evaluation. Outcome measures were categorised into quality of life (QoL), fatigue, mood, health behaviour and social function. Six trials examined psychoeducation had inconsistent results, both during and after the primary treatment. Seven trials examined the effect of CBT, four of which given after primary treatment (range 6-12 weeks) demonstrated improvements in QoL; the other three CBT studies given during primary treatment (range 9-20 weeks) had inconsistencies. Five studies addressed social support and showed no conclusive impacts of this intervention.
  
  
  CONCLUSIONS
  Limited documentation exists on the efficacy of psychosocial rehabilitation interventions among BC patients. However, we found that patients might have QoL benefits from CBT given after primary BC treatment. More documentation is needed regarding the effects of CBT during primary treatment and the effects of psychoeducation and social support.
authors.affiliation: Department of Psychiatry, St Olav University Hospital, Trondheim, Norway. eafors@online.no
authors.forename: Egil A
authors.initials: EA
authors.lastname: Fors
authors.forename: Gro F
authors.initials: GF
authors.lastname: Bertheussen
authors.forename: Inger
authors.initials: I
authors.lastname: Thune
authors.forename: Lene K
authors.initials: LK
authors.lastname: Juvet
authors.forename: Ida-Kristin Ø
authors.initials: IK
authors.lastname: Elvsaas
authors.forename: Line
authors.initials: L
authors.lastname: Oldervoll
authors.forename: Gun
authors.initials: G
authors.lastname: Anker
authors.forename: Ursula
authors.initials: U
authors.lastname: Falkmer
authors.forename: Steinar
authors.initials: S
authors.lastname: Lundgren
authors.forename: Gunnar
authors.initials: G
authors.lastname: Leivseth
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D011788:Quality of Life / Q000523:psychology; D012944:Social Support