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Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, Part II : Immunologic effects

Savard Josée, Simard Sébastien, Ivers Hans et Morin Charles M.. (2005). Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, Part II : Immunologic effects. Journal of Clinical Oncology, 23, (25), p. 6097-6106.

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URL officielle: http://dx.doi.org/10.1200/JCO.2005.12.513

Résumé

PURPOSE: Cross-sectional studies suggest that clinical insomnia is associated with immune downregulation. However, there is a definite need for experimental studies on this question. The goal of this randomized controlled study was to assess the effect of an 8-week cognitive-behavioral therapy (CBT) for chronic insomnia on immune functioning of breast cancer survivors. Previous analyses of this study showed that CBT was associated with improved sleep and quality of life, and reduced psychological distress.

PATIENTS AND METHODS: Fifty-seven women with chronic insomnia secondary to breast cancer were randomly assigned to CBT (n = 27) or to a waiting-list control condition (WLC; n = 30). Peripheral-blood samples were taken at baseline and post-treatment (and postwaiting for WLC patients), as well as at 3-, 6-, and 12-month follow-up for immune measures, including enumeration of blood cell counts (ie, WBCs, monocytes, lymphocytes, CD3+, CD4+, CD8+, and CD16+/CD56+) and cytokine production (ie, interleukin-1-beta [IL-1beta] and interferon gamma [IFN-gamma]).

RESULTS: Patients treated with CBT had higher secretion of IFN-gamma and lower increase of lymphocytes at post-treatment compared with control patients. Pooled data from both treated groups indicated significantly increased levels of IFN-gamma and IL-1beta from pre- to post-treatment. In addition, significant changes in WBCs, lymphocytes, and IFN-gamma were found at follow-up compared with post-treatment.

CONCLUSION: This study provides some support to the hypothesis of a causal relationship between clinical insomnia and immune functioning. Future studies are needed to investigate the clinical impact of such immune alterations.

Type de document:Article publié dans une revue avec comité d'évaluation
Volume:23
Numéro:25
Pages:p. 6097-6106
Version évaluée par les pairs:Oui
Date:1 Septembre 2005
Sujets:Sciences sociales et humaines > Sciences sociales > Psychologie
Sciences de la santé
Sciences de la santé > Sciences médicales > Oncologie
Département, module, service et unité de recherche:Départements et modules > Département des sciences de la santé > Module de psychologie
Mots-clés:breast cancer, cognitive therapy, immune system, insomnia, treatment, cancer du sein, thérapie cognitive, système immunitaire, traitement, insomnie
Déposé le:22 déc. 2017 02:19
Dernière modification:22 déc. 2017 02:19
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