The effectiveness of mindfulness-based cognitive therapy in depression and serum cortisol levels in women with breast cancer and depressed women

Document Type : Research Paper

Authors

1 Ph.D. student, Department of Clinical Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.

2 Assistant professor, Department of Clinical of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.

3 Professor, Department of Radiology, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor Department of physiology, Shiraz Branch, Faculty of Science, Zand Institute of Higher Education, Shiraz, Iran.

Abstract

Introduction: This study aims to investigate the effectiveness of mindfulness-based cognitive therapy in depression and serum cortisol levels in women with breast cancer and depressed women.
 
Materials and Methods: In this clinical trial, 30 women with breast cancer who referred to Omid Hospital, Mashhad-Iran and 30 women with depression who referred to counseling clinics of Mashhad in 2020-2021 were selected by the convenience sampling method and were randomly assigned to four equal groups (2 experimental groups and 2 control groups). The experimental groups received mindfulness-based cognitive therapy during eight 90-120 minute sessions per week, while the control group did not receive any intervention. Research instruments included the Depression Inventory (BDI-II) and the blood samples to evaluate the cortisol levels. Data were analyzed through descriptive statistics, and the covariance analysis.
 
Results: The results of depressed people demonstrated that mindfulness-based cognitive therapy is effective to reduce depression and serum cortisol levels within the normal laboratory range (P< 0.001). Further, the findings of breast cancer women indicated that mindfulness-based cognitive therapy reduced depression and increased serum cortisol from low to moderate levels within the normal laboratory range (P< 0.001).
 
Conclusion: Mindfulness-based cognitive therapy can be effective in neurobiological mechanisms in addition to improving psychological symptoms in depressed individuals and cancer patients.

Keywords

References

  1. Gupta S, Coronado GD, Argenbright K, Brenner AT, Castañeda SF, Dominitz JA, et al. Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of Centers for Disease Control and Prevention–sponsored summit. CA Cancer J Clin 2020; 70(4): 283-98.
  2. Cernackova A, Durackova Z, Trebaticka  J, Mravec  B. Neuroinflammation and depressive disorder: The role of the hypothalamus. J Clin Neurosci 2020; 75: 5-10.
  3. Pilevarzadeh M, Amirshahi M, Afsargharehbagh R, Rafiemanesh H, Hashemi SM, Balouchi A. Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis. Breast Cancer Res Treat 2019; 176(3): 519-33.
  4. Luo Y, Zhang S, Zheng R, Xu L, Wu J. Effects of depression on heart rate variability in elderly patients with stable coronary artery disease. J Evid Based Med 2018; 11 (4): 242-5.
  5. McEwen BS, Akil H. Revisiting the stress concept: implications for affective disorders. J Neuroscience; 2020; 40(1): 12-21.
  6. Dhabhar FS. The short-term stress response–Mother nature’s mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity. Front Neuroendocrinol 2018; 49: 175-92
  7. Alenko A, Markos Y, Fikru C, Tadesse E, Gedefaw L. Association of serum cortisol level with severity of depression and improvement in newly diagnosed patients with major depressive disorder in Jimma medical center, Southwest Ethiopia. PLoS One 2020; 15(10): e0240668.
  8. Montero-Marin J, Garcia-Campayo J, Pérez-Yus MC, Zabaleta-del-Olmo E, Cuijpers P. Meditation techniques v. relaxation therapies when treating anxiety: A meta-analytic review. Psychol Med 2019; 49(13): 2118-33.
  9. Shields GS, Spahr CM, Slavich GM. Psychosocial interventions and immune system function: A systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry 2020; 77(10): 1031-43.
  10. Wu R, Liu LL, Zhu H, Su WJ, Cao ZY, Zhong SY, et al. Brief mindfulness meditation improves emotion processing. Front Neurosci 2019; 13: 1074.
  11. Delavar A. [Probability and applied statistics in psychology and educational sciences (with revisions and additions)]. Tehran: Roshd; 2018. (Persian)
  12. Crane R. Mindfulness-based cognitive therapy. Behav Cognit Psychother 2011; 39: 124-5.
  13. Roelofs J, van Breukelen G, de Graaf LE, Beck AT, Arntz A, Huibers MJ. Norms for the Beck Depression Inventory (BDI-II) in a large Dutch community sample. J Psychopathol Behav Assess 2013; 35(1): 93-8.
  14. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian‐language version of the Beck Depression Inventory‐Second edition: BDI‐II‐PERSIAN. Depress Anxiety 2005; 21(4): 185-92.
  15. Kenne Sarenmalm E, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med 2017; 6(5): 1108-22.
  16. Sedighi K, Saffarian Toosi M, Khadivi G. Effectiveness of mindfulness based cognitive therapy on anxiety and depression of divorced women. Journal of research in behavioural sciences 2021; 19(1): 149-60.
  17. Norouzi H, Hashemi E. The efficacy of Mindfulness-Based Cognitive Therapy (MBCT) on emotion regulation among patients with breast cancer. Iranian quarterly journal of breast disease 2017; 10(2): 38-48.
  18. Sanada K, Montero-Marin J, Barceló-Soler A, Ikuse D, Ota M, Hirata A, et al. Effects of mindfulness-based interventions on biomarkers and low-grade inflammation in patients with psychiatric disorders: A meta-analytic review. Int J Molec Sci 2020; 21(7): 2484.
  19. Parmentier FB, García-Toro M, García-Campayo J, Yañez AM, Andrés P, Gili M. Mindfulness and symptoms of depression and anxiety in the general population: The mediating roles of worry, rumination, reappraisal and suppression. Front Psychol 2019; 10: 506.
  20. Rahmanian M, Oraki M, Pourfarid Z, Borhani M. The effect of cognitive therapy based on mindfulness on perceived stress, psychological capitals and emotional processing in women with breast cancer. Journal of fundamentals of mental health 2021; 23(3): 155-60.
  21. Zhang Q, Zhao H, Zheng Y. Effectiveness of mindfulness-based stress reduction (MBSR) on symptom variables and health-related quality of life in breast cancer patients—a systematic review and meta-analysis. Support Care Cancer 2019; 27(3): 771-81.
  22. Almeida SN, Elliott R, Silva ER, Sales CM. Fear of cancer recurrence: A qualitative systematic review and meta-synthesis of patients' experiences. Clin Psychol Rev 2019; 68: 13-24.
  23. Schell LK, Monsef I, Wöckel A, Skoetz N. Mindfulness‐based stress reduction for women diagnosed with breast cancer. Cochrane Database of Syst Rev 2019; 3(3): CD011518.
  24. Timm C, Rachota-Ubl B, Beddig T, Zamoscik VE, Ebner-Priemer U, Reinhard I, et al. Mindfulness based attention training improves cognitive and affective processes in daily life in remitted patients with recurrent depression. Psychother Psychosom 2018; 87(3): 184-6.
  25. Ter Avest MJ, Dusseldorp E, Huijbers MJ, van Aalderen JR, Cladder-Micus MB, Spinhoven P, et al. Added value of mindfulness-based cognitive therapy for depression: A tree-based qualitative interaction analysis. Behav Res Ther 2019; 122: 103467.
  26. Kuhnt S, Friedrich M, Schulte T, Cella D, Hinz A. Screening properties of the diagnostic criteria for cancer-related fatigue. Oncol Res Treat 2019; 42(9): 440-7.
  27. Hamer J, McDonald R, Zhang L, Verma S, Leahey A, Ecclestone C, et al. Quality of life (QOL) and symptom burden (SB) in patients with breast cancer. Support Care Cancer 2017; 25(2): 409-19.
  28. Denlinger CS, Sanft T, Baker KS, Broderick G, Demark-Wahnefried W, Friedman DL, et al. Survivorship, version 2.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2018; 16(10): 1216-47.
  29. Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, et al. Cancer-related fatigue, version 2.2015. J Natl Compr Canc Netw 2015; 13(8): 1012-39.
  30. Mirmahmoodi M, Mangalian P, Ahmadi A, Dehghan M. The effect of mindfulness-based stress reduction group counseling on psychological and inflammatory responses of the women with breast cancer. Integr Cancer Sci Ther 2020; 19: 1534735420946819.
  31. Farhangi A. [Effectiveness of mindfulness based cognitive therapy chronic pain management on psycho-social function in women with breast cancer]. Journal of education in counseling and psychotherapy 2019; 8: 11-28. (Persian)
  32. Herriot H, Wrosch C, Hamm JM, Pruessner JC. Stress-related trajectories of diurnal cortisol in older adulthood over 12 years. Psychoneuroendocrinology 2020; 121: 104826.
  33. Brown LC, Murphy AR, Lalonde CS, Subhedar PD, Miller AH, Stevens JS. Posttraumatic stress disorder and breast cancer: Risk factors and the role of inflammation and endocrine function. Cancer 2020; 126(14): 3181-91.
  34. Gold PW, Machado-Vieira R, Pavlatou MG. Clinical and biochemical manifestations of depression: Relation to the neurobiology of stress. Neural Plast 2015; 2015: 581976.
  35. Moica T, Gabos Grecu I, Buicu GE, Ferencz M, Gabos Grecu M, Sălcudean A, et al. Increased cortisol level sin depression: A comparative study evaluating the correlation of hypercortisolemia with prosocial coping mechanisms. Acta Med Marisiensis 2016; 62(1): 68-72.
  36. Wayne PM, Lee MS, Novakowski J, Osypiuk K, Ligibel J, Carlson LE, et al. Tai Chi and Qigong for cancer-related symptoms and quality of life: A systematic review and meta-analysis. J Cancer Surviv 2018; 12(2): 256-67.
  37. Luo XC, Liu J, Fu J, Yin HY, Shen L, Liu ML, et al. Effect of Tai Chi Chuan in breast cancer patients: A systematic review and meta-analysis. Front Oncol 2020; 10: 607.
  38. Michalak J, Probst T, Heidenreich T, Bissantz N, Schramm E. Mindfulness-based cognitive therapy and a group version of the cognitive behavioral analysis system of psychotherapy for chronic depression: Follow-up data of a randomized controlled trial and the moderating role of childhood adversities. Psychother Psychosom 2016; 85(6): 378-80
  39. Tang YY, Hölzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci 2015; 16(4): 213-25.
  40. Amihai I, Kozhevnikov M. The influence of Buddhist meditation traditions on the autonomic system and attention. Biomed Res Int 2015; 2015: 731579.
Journal of Fundamentals of Mental Health
Volume 24, Issue 6
November and December 2022
Pages 419-426

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