Cognitive behaviour therapy for menopausal symptoms following breast cancer treatment: who benefits and how does it work?
Open accessAbstract
Objectives Cognitive behaviour therapy (CBT) has been found to reduce the impact of menopausal symptoms, hot flushes and night sweats. This study investigates the moderators and mediators of CBT for women who had problematic menopausal symptoms following breast cancer treatment.Study design Analysis of 96 patients with breast cancer induced menopausal symptoms recruited to the MENOS1 trial; 47 were randomly assigned to Group CBT and 49 to usual care. Questionnaires were completed at baseline, 9 and 26 weeks post randomisation. Potential moderators and mediators, including sociodemographic, clinical and psychological factors, of the treatment effect on the primary outcome were examined.Main outcome measure Hot Flush Problem Rating.Results CBT was effective at reducing problem rating at 9 weeks regardless of age, BMI, time since breast cancer diagnosis, menopausal status at time of diagnosis, or type of cancer treatment (radiotherapy or chemotherapy or endocrine treatment). The treatment effect was significantly greater in women not receiving chemotherapy, those with higher levels of psychological distress at baseline and for non-white women. Beliefs about control/coping with hot flushes were the main mediators of improvement in problem rating following CBT. Beliefs about hot flushes in a social context, depressed mood and sleep problems were also identified as mediators.Conclusions These findings suggest that CBT is widely applicable for breast cancer patients who are experiencing treatment related menopausal symptoms, and that CBT works mainly by changing beliefs and improving mood and sleep.
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Chilcot et al. (2014) found support for the effectiveness of CBT based on the Women's Health Questionnaire (WHQ).
“Chilcot et al. (2014) found support for the effectiveness of CBT based on Women's Health Questionnaire (WHQ)”
From The effectiveness of psychosocial interventions on non-physiological symptoms of menopause: A systematic review and meta-analysis (2024) · cites this paper as Chilcot et al., 2014
The Stress and mood measures section (2.2.3; page unavailable) says WHQ subscales measured depressed mood, anxiety, and sleep problems, and Statistical analysis (2.3) reports improvements in those outcomes with CBT. However, the paper assesses CBT’s effect on hot flushes and night sweats using a separate symptom problem rating, not the WHQ; the WHQ scores also serve as moderators of that effect in Results (3.1). Thus the WHQ supports some benefits of CBT, but not the paper’s primary effectiveness finding. (LLM, conf=0.84)
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References 33 · Cited by 45
Research works printed but not linked: 1
- Van Breukelen GJ. ANCOVA versus change from baseline: more power in ran- domized studies, more bias in nonrandomized studies [corrected]. Journal of Clinical Epidemiology 2006;59(9):920-5.
- Authors
- Chilcot, J., Norton, S., & Hunter, M. S.
- Affiliations
- King's College London (GB)
- Corresponding author
- Hunter, Myra S.
- Venue
- Maturitas
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 78
- Issue
- 1
- Pages
- 56-61
- ISSN
- 0378-5122 (ISSN-L)
- OpenAlex
- W2029756647
- Cited by
- 45
- References
- 33
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 1
- FWCI
- 4.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Maturitas (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Cancer Research UK (C8303/A6130)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- cognitive behavioral therapy, menopausal symptoms, breast cancer, hot flashes, night sweats, mediators and moderators, psychological distress, coping beliefs, sleep disorders, depression, chemotherapy, radiotherapy, endocrine therapy
- MeSH terms
- Breast Neoplasms, Culture, Depression, Ethnicity, Female, Humans, Menopause, Middle Aged, Surveys and Questionnaires, Sleep Wake Disorders, Social Environment, Stress, Psychological, Sweating, Cognitive Behavioral Therapy, Hot Flashes, Self Efficacy
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