Mind over Malignancy: A Systematic Review and Meta-Analysis of Psychological Distress, Coping, and Therapeutic Interventions in Oncology
Abstract
1. Introduction
1.1. Main Review Question
- i.
- Null Hypothesis (H0): Structured psychotherapeutic, mindfulness-based, and resilience-enhancing interventions yield no statistically significant improvements in depression, anxiety, distress, coping capacity, or quality of life.
- ii.
- Alternative Hypothesis (H1): Structured psychotherapeutic approaches (e.g., CBT, ACT, MCP), mindfulness-based therapies (e.g., MBSR, MBCT), and coping/resilience-enhancing programs (e.g., PRISM) are associated with statistically and clinically significant improvements in one or more of these outcomes.
1.2. Background
1.2.1. Conceptual Convergence of Psychotherapeutic Interventions in Oncology
1.2.2. Methodological Gaps and Challenges in the Current Literature
1.2.3. Temporal Relevance and Evidence Currency in Psychosocial Oncology
1.3. Rationale
1.3.1. Clinical Imperatives and Unmet Needs
1.3.2. Theoretical Foundations and Empirical Rationale for the Review
1.4. Objectives and Methodological Framework
2. Materials and Methods
2.1. Protocol and Registration
2.2. Inclusion Parameters and Screening Logic
2.3. Psychological Intervention Typologies and Inclusion Rationale
2.4. Analytical Inference Models and Meta-Analytic Parameters
2.5. Software Ecosystem and Statistical Implementation Infrastructure
2.6. Search Infrastructure and Source Coverage Strategy
2.7. Study Selection Procedures and Validation Pathway
2.8. Data Extraction and Synthesis Structuring Protocol
2.9. Quality Appraisal and Risk of Bias Assessment
- Structured Psychotherapeutic Interventions
- 2.
- Mindfulness-Based and Stress Reduction Interventions
- 3.
- Coping and Psychological Resilience Interventions
3. Results
3.1. Statistical Descriptives and Methodological Profile of Included Studies
3.2. Structural Synthesis Approach and Integration Logic
3.3. Meta-Analytic Outcomes: Efficacy Across Domains and Interventions
3.3.1. General Meta-Analysis Across Each Intervention Category
- A.
- Structured Psychotherapeutic Interventions
- B.
- Mindfulness and Stress Reduction Interventions
- C.
- Coping and Psychological Resilience Interventions
3.3.2. Subgroup Comparison of CBT-Based Versus Supportive/Expressive Approaches
3.3.3. Meta-Regression with Intervention Type as a Moderator
4. Discussion
4.1. Synthesis of Evidence and Resolution of the Central Hypothesis
4.2. Distillation of Core Findings and Meta-Analytic Narrative
4.3. Comparison with Previous Literature
4.4. Limitations
4.5. Clinical and Policy Implications
4.6. Future Research Directions
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Intervention Category | Example Therapies | Primary Outcomes Assessed | General Efficacy Notes * |
---|---|---|---|
Structured Psychotherapeutic Interventions | Cognitive Behavioral Therapy (CBT); Acceptance and Commitment Therapy (ACT). | Depression, anxiety, psychological distress | Trend toward reduced distress but not statistically significant (t14 = −1.99, p = 0.066). Very high heterogeneity (I2 = 95%, τ2 = 0.9228). Supportive/expressive subgroups showed larger effects than CBT (SMD = −1.68 vs. −0.43), though differences were not significant. |
Mindfulness-Based and Stress Reduction Programs | Mindfulness-Based Stress Reduction (MBSR); Mindfulness-Based Cognitive Therapy. | Distress, anxiety, fatigue, emotional regulation | Moderate, non-significant reductions in distress and anxiety (t12 = −1.58, p = 0.14). High heterogeneity (I2 = 87%, τ = 0.38). Notable improvements in fatigue and sleep (secondary outcomes). No clear evidence of publication bias. |
Coping and Resilience-Enhancing Interventions | Promoting Resilience in Stress Management (PRISM); expressive writing. | Anxiety, depression, coping skills, psychological growth | Statistically significant moderate reduction in distress (t13 = −2.47, p = 0.028). High heterogeneity (I2 = 83%, τ2 = 0.33). After trim-and-fill adjustment (5 imputed studies), pooled effect attenuated to −0.09 (−0.54 to 0.35), indicating sensitivity to publication bias. Interventions often improved coping self-efficacy and quality of life. |
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© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Paslaru, A.M.; Plesea-Condratovici, A.; Moroianu, L.-A.; Isailă, O.-M.; Rebegea, L.F.; Pavel, L.L.; Ciubară, A. Mind over Malignancy: A Systematic Review and Meta-Analysis of Psychological Distress, Coping, and Therapeutic Interventions in Oncology. Medicina 2025, 61, 1086. https://doi.org/10.3390/medicina61061086
Paslaru AM, Plesea-Condratovici A, Moroianu L-A, Isailă O-M, Rebegea LF, Pavel LL, Ciubară A. Mind over Malignancy: A Systematic Review and Meta-Analysis of Psychological Distress, Coping, and Therapeutic Interventions in Oncology. Medicina. 2025; 61(6):1086. https://doi.org/10.3390/medicina61061086
Chicago/Turabian StylePaslaru, Ana Maria, Alina Plesea-Condratovici, Lavinia-Alexandra Moroianu, Oana-Maria Isailă, Laura Florentina Rebegea, Liliana Lacramioara Pavel, and Anamaria Ciubară. 2025. "Mind over Malignancy: A Systematic Review and Meta-Analysis of Psychological Distress, Coping, and Therapeutic Interventions in Oncology" Medicina 61, no. 6: 1086. https://doi.org/10.3390/medicina61061086
APA StylePaslaru, A. M., Plesea-Condratovici, A., Moroianu, L.-A., Isailă, O.-M., Rebegea, L. F., Pavel, L. L., & Ciubară, A. (2025). Mind over Malignancy: A Systematic Review and Meta-Analysis of Psychological Distress, Coping, and Therapeutic Interventions in Oncology. Medicina, 61(6), 1086. https://doi.org/10.3390/medicina61061086