Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria

Depression is common among patients diagnosed with advanced or metastatic breast cancer (BC), with the diagnosis often associated with severe emotional and psychological decline that may result from the disease or from treatment-related toxicity. Cognitive Behavioral Therapy (CBT) has emerged as one of the most evidence-based and effective psychotherapeutic approaches for the management of depression and anxiety in cancer populations but its implementation, use and role in the management of depression among advanced BC patients in low resource settings remains limited. Therefore, this study aimed to evaluate the effectiveness of CBT in reducing depressive symptoms among patients with advanced breast cancer patients receiving treatment at the University of Nigeria Teaching Hospital, Enugu. This study investigated the role of a six (6) week group CBT on depression among advanced BC patients. The study adopted randomized controlled Pre-test Post-test design. Forty two (42) advanced breast cancer patients were randomly divided into two groups: CBT group (n= 20) and control group (n= 22). The CBT group received a 6 week, 90 minutes CBT sessions once a week and the control group only received their cancer treatment and patient navigation assistance. Assessment was carried out for both groups at baseline (Pre-test) and the intervention. A total of BC patients were accessed for depression of which 42 patients recruited and 27 patients completed the study. Baseline assessment of participants showed mean depression scores of 12.05 ± 1.61 for CBT group and 12.77 ± 1.95 for the control groups (p=0.20). Post intervention assessment result showed that participants in the CBT group reported a significantly greater decrease in depression (3.50 ± 0.94) compared to participants in the control group (13.23 ± 1.78) (p<0.001). Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Implementing CBT into practice may appear challenging at first, but efforts to help these patients in achieving better all-around health are efforts well spent.