Efficacy of group therapy to reduce mental distress in women with non-metastatic breast cancer: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: Group treatments have proven to be effective for many mental disorders and showed beneficial effects in patients with medical illness. Aim of this systematic review and meta-analysis is to summarize the efficacy of group therapy for women with non-metastatic breast cancer. METHODS: We included studies comparing group therapy for women with non-metastatic breast cancer to non-active control groups, active control conditions, and individual psychotherapy. The primary outcome was mental distress, secondary outcomes were quality of life, coping, existential outcomes, fatigue, pain, and side effects. A comprehensive search was conducted in Medline, Web of Science, CENTRAL, PsycINFO, and DARE complemented by a manual search. Random-effects meta-analyses were run separately for different types of control groups. RESULTS: Thirty-seven studies (5902 patients) were included. Small effects on mental distress in favor of group treatment were found (non-active control groups: n = 19, g = 0.42, 95% CI [0.29; 0.56], I2  = 61.6%; active control conditions: n = 6, g = 0.20, 95% CI [0.06; 0.35], I2  = 0%). Cognitive-behavioral therapy (CBT) and third wave CBT group approaches proved to be most effective. Group treatments also showed beneficial effects on secondary outcomes, with most profound evidence on quality of life and coping. CONCLUSIONS: Results suggest that group interventions have the potential to reduce mental distress in women facing breast cancer. In the light of the considerable heterogeneity of most study effects, there is a need for more rigorous studies to strengthen the promising evidence and for trials examining the impact of patient and intervention characteristics on outcomes. REGISTRATION: PROSPERO international prospective register of systematic reviews, CRD42020184357.

School-Based Interventions Improve Body Image and Media Literacy in Youth: A Systematic Review and Meta-Analysis.

Body ideals conveyed by the media and by body comparisons often result in body dissatisfaction, which can cause risky health behaviours and eating disorders, especially in adolescents. We conducted a meta-analytic review of existing school-based interventions designed to enhance media literacy in order to reduce body dissatisfaction and to promote a positive body image. We included controlled trials examining children and adolescents from grade five to nine (age 10-15 years) after a manual search and a comprehensive literature search using PsycINFO, Medline, Web of Science, and CENTRAL. We computed average weighted effect sizes (Hedges' g) with the help of a random effects model and identified seventeen different programme evaluations with 7392 participants. We found a significantly larger effect on positive body image and media literacy in the intervention compared to control groups. However, heterogeneity was substantial for both outcomes. Results suggest that media literacy interventions have the potential to improve media literacy and reduce body dissatisfaction. Interventions that worked with the principle of induction of cognitive dissonance were the most effective.