THE EFFECTIVENESS OF MINDFULNESS-BASED THERAPIES VERSUS COGNITIVE BEHAVIOURAL THERAPIES IN IMPROVING THE EMOTIONAL QUALITY OF LIFE AMONG BREAST CANCER SURVIVORS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background/Aims: Breast cancer is the most commonly diagnosed female cancer globally. Aggressive treatments and extensive use of mammographic screening have increased breast cancer survivorship. The ubiquity of breast cancer diagnosis and survivorship necessitates an examination whether mindfulness-based therapies and cognitive behavioural therapies are effective in reducing the depressive and anxious symptoms breast cancer survivors face. The association of emotional quality of life to depression and anxiety entails a probe into whether the aforementioned interventions are also effective for the emotional quality of life. Methods: A search of eight databases (EMBASE, PubMed, The Cochrane Library, SCOPUS, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, ScienceDirect and Web of Science) was conducted. Studies were included if they were randomised controlled trials conducted on female breast cancer survivors, compared either mindfulness-based therapies or cognitive behavioural therapies against usual care and included depression, anxiety and quality of life as its outcome. Results: Twelve randomised controlled trials included in the review were evaluated to be of moderate quality according to the GRADE framework and The Cochrane Handbook Risk of Bias tool. Comparing the effect sizes of both therapies on the three outcomes of interest, it revealed that cognitive behavioural therapies was more effective for reducing depression and anxiety while mindfulness-based therapies was more efficacious for improving emotional quality of life. Implications: There is a need to screen for signs of depression and anxiety and identify factors that could result in a lower emotional quality of life in breast cancer patients. Future systematic reviews can assess the efficacy of cognitive behavioural therapies and mindfulness-based therapies on other undesirable effects of breast cancer. Conclusions: Cognitive behavioural therapies are recommended for breast cancer survivors experiencing depression and anxiety, while mindfulness-based therapies are recommended for all breast cancer survivors.