Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T13:16:35.648Z Has data issue: false hasContentIssue false
  • English
  • Français

Mindfulness-based cognitive therapy for psycho-oncology patients: an exploratory study

Published online by Cambridge University Press:  07 January 2015

T. Kingston ,
S. Collier ,
D. Hevey ,
M. M. McCormick ,
C. Besani ,
J. Cooney  and
A. M. O’Dwyer
T. Kingston*
Affiliation:
Department of Psychological Medicine, St James’s Hospital, James St. Dublin 8, Ireland
S. Collier
Affiliation:
Department of Psychological Medicine, St James’s Hospital, James St. Dublin 8, Ireland
D. Hevey
Affiliation:
Department of Psychological Medicine, St James’s Hospital, James St. Dublin 8, Ireland Department of Psychology, Trinity College, Dublin 2, Ireland
M. M. McCormick
Affiliation:
Department of Psychological Medicine, St James’s Hospital, James St. Dublin 8, Ireland
C. Besani
Affiliation:
Department of Psychological Medicine, St James’s Hospital, James St. Dublin 8, Ireland
J. Cooney
Affiliation:
Department of Psychological Medicine, St James’s Hospital, James St. Dublin 8, Ireland
A. M. O’Dwyer
Affiliation:
Department of Psychological Medicine, St James’s Hospital, James St. Dublin 8, Ireland
*
*Address for correspondence: Dr T. Kingston, Department of Psychological Medicine, St James’s Hospital, James St, Dublin 8, Ireland. (Email: takingston@stjames.ie)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Mindfulness-based cognitive therapy (MBCT) is a group-based intervention similar to mindfulness-based stress reduction, but which includes cognitive therapy techniques. This study investigates its usefulness in the treatment of depressive, anxiety and stress/distress symptoms in cancer patients referred to a psycho-oncology service. It also examines whether effect on depression is mediated by self-compassion.

Method

In phase 1 of this study, 16 cancer patients with mild/moderate psychological distress were randomised to MBCT (n=8) or treatment as usual (TAU; n=8), and assessed pre- and post-treatment. Analysis of variance was performed to examine the effect of treatment on anxiety and depression. In phase 2, the TAU group received the intervention, and results of pre- and post-MBCT assessments were combined with those receiving MBCT in phase 1. Finally, both groups were followed up at 3 months.

Results

In phase 1, the MBCT group had a significant improvement in mindfulness and a decrease in anxiety. Statistically significant improvements in both depression and anxiety were found at 3 month follow-up. Self-compassion appeared to mediate the effect on anxiety/depression.

Conclusion

This small pilot study suggests that MBCT may have a beneficial effect on psychological variables often adversely affected in cancer in a heterogeneous cancer population.

Keywords

Anxietycancerdepressionmindfulnessmindfulness-based cognitive therapy
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 32 , Issue 3 , September 2015 , pp. 265 - 274
Copyright
© College of Psychiatrists of Ireland 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexander, PJ, Dinesh, N, Vidyasagar, MS (1993). Psychiatric morbidity among cancer patients and its relationship with awareness of illness and expectations about treatment outcome. Acta Oncologica Scandinavica 32, 623–626.CrossRefGoogle ScholarPubMed
Baer, RA, Smith, GT, Allen, KB (2004). Assessment of mindfulness by self-report: the Kentucky inventory of mindfulness skills. Assessment 11, 191–206.CrossRefGoogle ScholarPubMed
Bartley, T (2011). Mindfulness-Based Cognitive Therapy for Cancer. Wiley-Blackwell: Oxford.CrossRefGoogle Scholar
Bech, P (1998). Quality of Life in the Psychiatric Patient. Mosby Wolfe: London.Google Scholar
Carlson, LE, Garland, SN (2005). Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients. International Journal of Behavioural Medicine 12, 278–285.Google ScholarPubMed
Carlson, LE, Speca, M, Patel, KD, Goodey, E (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine 65, 571–581.CrossRefGoogle ScholarPubMed
Carlson, LE, Speca, M, Patel, KD, Goodey, E (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dihydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology 29, 448–474.CrossRefGoogle Scholar
Carlson, LE, Ursuliak, Z, Goodey, E, Angen, M, Speca, M (2001). The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Support ive Care in Cancer 9, 112–123.CrossRefGoogle ScholarPubMed
Carr, DB, Goudas, LC, Lawrence, D, Pirl, W, Lau, J, DeVine, D, Kupelnick, B, Miller, K (2002). Management of Cancer Symptoms: Pain, Depression, and Fatigue. Agency for Healthcare Research and Quality: Maryland.Google ScholarPubMed
Cramer, H, Lauche, R, Dobos, G (2012). Mindfulness-based stress reduction (MBSR) for breast cancer: a systematic review of randomized-controlled trials. BMC Complementary Medicine 12, 226.CrossRefGoogle Scholar
Derogatis, LR (1993). BSI Brief Symptom Inventory. Administration, Scoring and Procedures Manual, 4th edn.. National Computer Systems: Minneapolis.Google Scholar
Derogatis, LR, Morrow, GR, Fetting, J (1983). The prevalence of psychiatric disorders among cancer patients. Journal of the American Medical Association 249, 751–757.CrossRefGoogle ScholarPubMed
Foley, E, Baillie, A, Huxter, M, Price, M, Sinclair, E (2010). Mindfulness-based cognitive therapy for individuals whose lives have been affected by cancer: a randomized controlled trial. Journal of Clinical & Consulting Psychology 78, 72–79.CrossRefGoogle ScholarPubMed
Griffiths, K, Camic, PM, Hutton, JM (2009). Participant experiences of a mindfulness-based cognitive therapy group for cardiac rehabilitation. Journal of Health Psychology 14, 675–681.CrossRefGoogle Scholar
Hayes, C, Luoma, B, Bond, F, Masuda, A, Lillis, J (2004). Acceptance and commitment therapy: model processes and outcomes. Behaviour Research and Therapy 44, 1–25.CrossRefGoogle Scholar
Heidenreich, T, Tuin, I, Pflug, B, Michal, M, Michalak, J (2006). Mindfulness-based cognitive therapy for persistent insomnia: a pilot study. Psychotherapy & Psychosomatics 75, 188–189.CrossRefGoogle ScholarPubMed
Holland, JC (1989). Clinical course of cancer. In Handbook of Psychooncology: Psychological Care of the Patient With Cancer (ed J. C. Holland and J. H. Rowland), pp. 75–100. Oxford University Press: New York.Google Scholar
Hoppes, K (2006). The application of mindfulness-based cognitive interventions in the treatment of co-occurring addictive and mood disorders. CNS Spectrums 11, 829–851.CrossRefGoogle ScholarPubMed
Kabat-Zinn, J (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. Delacorte: New York.Google Scholar
Keng, SL, Smoski, MJ, Robins, CJ, Ekblad, AG, Brantley, JG (2012). Mechanisms of change in mindfulness-based stress reduction: self-compassion and mindfulness as mediators of intervention outcomes. Journal of Cognitive Psychotherapy 26, 270–280.CrossRefGoogle Scholar
Kieviet-Stijnen, A, Visser, A, Garssen, B, Hudig, W (2008). Mindfulness-based stress reduction training for oncology patients: patients’ appraisal and changes in well-being. Patient Education and Counselling 72, 436–442.CrossRefGoogle ScholarPubMed
Kyrimis, M (2007). An examination of the relationships among mindfulness, emotional acceptance, emotional awareness, self-compassion, forgiveness, and self-judgment. Dissertation Abstracts International: Section B: The Sciences and Engineering 68, 1931.Google Scholar
Lamanque, P, Daneault, S (2006). Does meditation improve the quality of life for patients living with cancer? Canadian Family Physician 52, 474–475.Google ScholarPubMed
Ledesma, D, Kumano, H (2008). Mindfulness-based stress reduction and cancer: a meta-analysis. Psycho-Oncology 18, 571–579.CrossRefGoogle Scholar
Lengacher, CA, Johnson-Mallard, V, Post-White, J, Moscoso, MS, Jacobsen, PB, Klein, TW, Widen, RH, Fitzgerald, SG, Shelton, MM, Barta, M, Goodman, M, Cox, CE, Kip, KE (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psycho-Oncology 218, 1261–1272.CrossRefGoogle Scholar
Ma, SH, Teasdale, JD (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting & Clinical Psychology 72, 31–40.CrossRefGoogle ScholarPubMed
Massie, MJ (2004). Prevalence of depression in patients with cancer. JNCI Monographs 32, 57–71.CrossRefGoogle Scholar
Massie, MJ, Holland, JC (1989). Overview of normal reactions and prevalence of psychiatric disorders. In Psychological Care of the Patient with Cancer: Handbook of Psychooncology (ed. J. C. Holland and H. Rowland), pp. 273–282. Oxford University Press: New York.Google Scholar
McDowell, I (2010). Measures of self-perceived well-being. Journal of Psychosomatic Research 69, 69–79.CrossRefGoogle ScholarPubMed
McIntosh, E, Gillanders, D, Rodgers, S (2010). Rumination, goal linking, daily hassles and life events in major depression. Clinical Psychology & Psychotherapy 17, 33–43.CrossRefGoogle ScholarPubMed
McNair, DM, Heuchert, JWP, Shilony, E (2003). Profile of Mood States Bibliography 1964-2002. Multi-Health Systems: New York.Google Scholar
McNair, DM, Lorr, M, Droppleman, LF (1971). Manual: Profile of Mood States. Educational and Industrial Testing Service: California.Google Scholar
Meyer, F, Ehrlich, M, Peteet, M (2009). Psycho-oncology: a review for the general psychiatrist. Focus 7, 317–331.CrossRefGoogle Scholar
Michalak, J, Heidenreich, T, Meibert, P, Schulte, D (2008). Mindfulness predicts relapse/recurrence in major depressive disorder after mindfulness-based cognitive therapy. Journal of Nervous & Mental Disease 196, 630–633.CrossRefGoogle ScholarPubMed
Mykletun, A, Stordal, E, Dahl, AA (2001). Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. British Journal of Psychiatry 179, 540–544.CrossRefGoogle ScholarPubMed
Neff, KD (2003). Development and validation of a scale to measure self-compassion. Self and Identity 2, 223–250.CrossRefGoogle Scholar
Neff, KD, Rude, SS (2007). An examination of self-compassion in relation to positive psychological functioning and personality traits. Journal of Research in Personality 241, 908–916.CrossRefGoogle Scholar
Ott, MJ, Norris, RL, Bauer-Wu, SM (2008). Mindfulness meditation for oncology patients: a discussion and critical review. Integrative Cancer Therapies 5, 98–108.CrossRefGoogle Scholar
Pauley, G, McPherson, S (2010). The experience and meaning of compassion and self-compassion for individuals with depression or anxiety. Psychology & Psychotherapy 83, 129–143.CrossRefGoogle ScholarPubMed
Popkin, MK, Callies, AL, Colόn, EA, Stiebel, V (1990). Adjustment disorders in medically ill inpatients referred for consultation in a university hospital. Psychosomatics 31, 410–414.CrossRefGoogle ScholarPubMed
Prieto, JM (2002). Psychiatric morbidity and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. Journal of Clinical Oncology 20, 1907–1917.CrossRefGoogle ScholarPubMed
Raes, F, Dewulf, D, Van Heeringen, C, Williams, JMG (2009). Mindfulness and reduced cognitive reactivity to sad mood: evidence from a correlational study and a non-randomized waiting list controlled study. Behavioural Research & Therapy 47, 623–627.CrossRefGoogle Scholar
Razavi, D, Delvaux, N, Farvacques, C, Robaye, E (1990). Screening for adjustment disorders and major depressive disorders in cancer inpatients. British Journal of Psychiatry 156, 79–83.CrossRefGoogle Scholar
Sadlier, M, Stephens, SD, Kennedy, V (2008). Tinnitus rehabilitation: a mindfulness meditation cognitive behavioural therapy approach. Journal of Laryngology & Otology 122, 31–37.CrossRefGoogle ScholarPubMed
Saxe, GA, Hebert, JR, Carmody, JF, Kabat-Zinn, J, Rosenzweig, PH, Jarzobski, D, Reed, GW, Blute, RD (2001). Can diet in conjunction with stress reduction affect the rate of increase in prostate specific antigen after biochemical recurrence of prostate cancer? Journal of Urology 166, 2202–2207.CrossRefGoogle ScholarPubMed
Schultz, KF, Grimes, DA (2002). Generation of allocation sequences in randomized trials: chance not choice. The Lancet 359, 515–519.CrossRefGoogle Scholar
Segal, ZV, Williams, JMG, Teasdale, J (2002). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. Guilford Press: New York.Google Scholar
Shapiro, SL, Bootzin, RR, Figueredo, AJ, Lopez, AM, Schwartz, GE (2004). The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: an exploratory study. Journal of Psychosomatic Research 54, 85–91.CrossRefGoogle Scholar
Sharplin, GR, Jones, SBW, Hancock, B, Knott, VE, Bowden, JA, Whitford, HS (2010). Mindfulness-based cognitive therapy: an efficacious community-based group intervention for depression and anxiety in a sample of cancer patients. The Medical Journal of Australia 193, 79.CrossRefGoogle Scholar
Smith, JE, Richardson, J, Hoffman, C, Pilkington, K (2005). Mindfulness-based stress reduction as supportive therapy in cancer care: systematic review. Journal of Advances in Nursing 52, 315–327.CrossRefGoogle ScholarPubMed
Snyder, S, Strain, JJ, Wolf, D (1989). Differentiation of major depression and adjustment disorder with depressed mood in the medical setting. General Hospital Psychiatry 12, 159–165.CrossRefGoogle Scholar
Speca, MP, Carlson, LE (2011). Mindfulness-Based Cancer Recovery: A Step-by-step MBSR Approach to Help You Cope With Treatment and Reclaim Your Life. New Harbinger Publications: California.Google Scholar
Speca, M, Carlson, LE, Goodey, E, Angen, M (2000). A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine 62, 613–622.CrossRefGoogle ScholarPubMed
Tacon, AM, Caldera, YM, Ronaghan, C (2004). Mindfulness-based stress reduction in women with breast cancer. Families, Systems & Health 22, 193–203.CrossRefGoogle Scholar
Teasdale, JD, Segal, ZV, Williams, JMG, Ridgeway, V, Soulsby, J, Lau, M (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 68, 615–623.CrossRefGoogle ScholarPubMed
Van der Lee, ML, Garssen, B (2012). Mindfulness-based cognitive therapy reduces chronic cancer-related fatigue: a treatment study. Psycho-Oncology 21, 264–272.CrossRefGoogle ScholarPubMed
Williams, JM, Alatiq, Y, Crane, C, Barnhofer, T, Fennell, MJ, Duggan, DS, Hepburn, S, Goodwin, GM (2008). Mindfulness-based cognitive therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on between-episode functioning. Journal of Affective Disorders 10, 275–279.CrossRefGoogle Scholar
Williams, JM, Duggan, DS, Crane, C, Fennell, MJ (2006). Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior. Journal of Consulting & Clinical Psychology 62, 201–210.CrossRefGoogle ScholarPubMed
Witek-Janusek, L, Albutquerque, K, Chroniak, KR, Chroniak, C, Durazo-Arvizu, R, Mathews, HL (2008). Effect of mindfulness-based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain, Behavior and Immunity 22, 969–981.CrossRefGoogle ScholarPubMed
Yook, K, Lee, SH, Ryu, M, Kim, KH, Choi, TK, Suh, SY, Kim, YW, Kim, B, Kim, MY, Kim, MJ (2008). Usefulness of mindfulness-based cognitive therapy for treating insomnia in patients with anxiety disorders: a pilot study. Journal of Nervous & Mental Disease 196, 501–503.CrossRefGoogle ScholarPubMed
Zabora, J, BrintzenfhofeSzoc, K, Jacobsen, P, Curbow, B, Piantadosi, S, Hooker, C, Owens, A, Derogatis, L (2000). A new psychosocial screening instrument for use with cancer patients. Psychosomatics 42, 241–246.CrossRefGoogle Scholar
Zigmond, AS, Snaith, RP (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed