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تأثیر گروه‌درمانی شناختی-رفتاری بر افسردگی بیماران مبتلا به سرطان - مجله علمی دانشگاه علوم پزشکی بیرجند

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1- Park J. Park’s textbook of prevention and social medicine. Translated by: rafaei. K. 17th ed. Tehran: Ilia publication.

(2003) [Persian].

2- Azizi F, Hatami H, Janghorbani M. Epidemiology and control of prevalent disease in Iran. 2th ed. Tehran: Eshtiagh pubication (2000) [Persian].

3- Elkhani M. Methods of surveillance in cancer. Tehran: Ghazi jahani publication (1991) [Persian].

4- Karimovi M, Poordehghan M, Faghihzadeh S, Montazeri A. Survey of effect of group counseling in functional scales quality of life in women with breast cancer under chemotherapy treatment. Daneshvar Sci Res J Shahed U. 2000;

13(62):69-78 [Persian].

5- Noghani F, Monjamed H, Bahrani N, Ghodarti V. The comparison of self esteem between male and female cancer patients. Mag Nurs Obstet Fac Tehran Med Sci Fac. 2006;12(2):33-41 [Persian].

6- Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early Breast cancer: Five year observational cohort study. BMJ. 2005;330(7493):702.

7- Büssing A, Fischer J, Ostermann T, Matthiessen PF. Reliance on God's help, depression and fatigue in female cancer patients. Int J Psychiatry Med. 2008;38(3):357-72.

8- Wasteson E, Brenne E, Higginson IJ, Hotopf M, Lloyd-Williams M, Kaasa S, et al. Depression assessment and classification in palliative cancer patients: a systematic literature review. Palliat Med. 2009;23(8):739-53.

9- So WK, Marsh G, Ling WM, Leung FY, Lo JC, Yeung M, et al. The symptom cluster of fatigue, pain, anxiety, and depression and the effect on the quality of life of women receiving treatment for breast cancer: a multicenter study.

Oncol Nurs Forum. 2009;36(4):E205-14.

10- Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics. 2009;50(4):383-91.

11- Dematheo M. Health psychology. Translated by: Kaviani M & Hashemian k. Tehran: SAMT publication. (2008) [Persian].

12- Oei TP, Dingle G. The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders. J Affect Disord. 2008;107(1-3):5-21.

13- Brother , Brittany Michelle. An examination of treatment for depression in femal cancer patients , The ohio state university. (2008) 177;AAT3375726.

14- Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med. 2006;36(1):13-34.

15- Hawton K, Salkours K, Clarck. Congnitive behavior Therapy for psychiatric problems, a practical guide. Translated by: Ghasem zadeh H. Tehran: Arjmand Publication (2003)[Persian].

16- Mehrabi T, Sheikholeslami F, Ghazavi Z, Nasiri M. The effect of group therapy on depression and anxiety levels of the patients with MI. Nurs Midwifery Search. 2004;29(7):5-13.[Persian]

17- Azimi H, Jannati Y, Mahmoudi G. Text of mental health nursing. Tehran: Salemi publication (2003) [Persian].

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18- Cappeliez P. Presentation of depression and response to group cognitive therapy with older adults. J Clin Gerontology. 2000:6(3):156-74.

19- Nietzel MT, Russel RT, Hemming KA, Gretter ML. Clinical significance of psychotherapy for unipolar depression:

a meta-analytic approach to comparison. J Consult Clin Psychol. 1987;55(9):156-61.

20- Hornsey MJ, Dwyer L, Oie TPS. Beyond cohesiveness: re-conceptualizing the link between group processes and outcomes in group psychotherapy .Small Gr Res. 2007;38:567-92.

21- Kaplan H, Sadock B. Synopsis of psychiatry: behavioral sciences, clinical psychiatry. Translated by: Rafei H &

sobhanian K. 4th ed. Tehran: Arjmand publication (2003).

22- Groth M, Gary. Handbook of psychologycal assessment. Translated by: Pashasharify H & Nikkhoo M. 2thed Tehran: Sokhan publication (1997). [Persian].

23- Simpson S, Carison E, Etrew M. Effect of group therapy for breast cancer on health carutilization , Cancer Prac.

2001;9(1):19-34.

24- Kush FR Fleming LM. An innovative approach to short-term group cognitive therapy in the combined treatment of anxiety and depression. Group Dynamics. 2000;4(11):176-83.

25- Peterson AL, Halistead TS. Group cognitive behavior therapy for depression in a community setting: a clinical replication series. Behav Ther.1987;29:3-18.

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Abstract Original Article

The Effect of Cognitive–Behavioral Group Therapy on Depression in Patients with Cancer

S. Khodai 1, R. Dastgerdi2, F. Haghighi3, S.A. Sadatjoo4, A. Keramati5

Background and Aim: One of the most common complications of cancer is subsequent psychological problems including depression, reduced vital function, and increased risk of mortality. The objective of this study was to evaluate the effectiveness of cognitive-behavioral group therapy on decreasing depression among patients with cancer in Birjand city.

Materials and Methods: This research was a semi-experimental study including pre-test, post-test and control group in which the statistical society consisted of patients with cancer who referred to Imam Reza hospital in Birjand. The samples included 24 patients with cancer who were selected based on DSM-IV distinctive standard and Beck depression inventory. The case group were treated by cognitive-behavioral therapy in 12 session of 1.5 hours, and the control group received no psychiatric therapy. The data were analyzed by T-Test and covariance analysis using version 15.00 of SPSS software.

Results: After treatment, depression in the case group decreased to 8.58±7.38 which was statistically significant (P<0.001); however depression in the control group (28.33±11.87) did not change.

Conclusion: Cognitive-behavioral group therapy plays an important role in decreasing depression in patients with cancer. Psychological intervention can help patients to change their cognition by decreasing depression and enable them to have a more positive belief in controlling themselves against dependency.

Key Words: depression, cancer, cognitive-behavioral group therapy

Journal of Birjand University of Medical Sciences. 2011; 17(3): 183- 190 Received: October 05, 2010 Accepted: December 07, 2010

1Corresponding Author; Ms in clinical psychology Islamic azad university, birjand, iran sajadkhodai@yahoo.com 2 Assistant professor, birjand university of medical sciences, birjand, iran

3 Associated professor, birjand university of Medical sciences,birjand, iran 4 Instructor, birjand university of Medical sciences, birjand, iran

5 Ms counceling psychology,mashhad university of ferdousi, mashhad, iran

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ﻪﺘﻓﺎﻳ جرد يﺎﻫ لوﺪﺟ رد هﺪﺷ 2 ﻲﻣ نﺎﺸﻧ ود ﻦﻴﺑ ﺪﻫد ﺚﻴﺣ زا ﻲﺷزﻮﻣآ ﻪﻠﺧاﺪﻣ ياﺮﺟا زا ﻞﺒﻗ لﺮﺘﻨﻛ و ﻲﺑﺮﺠﺗ هوﺮﮔ ﺺﺧﺎﺷ تﺎﻌﻓد ﻲﻨﻌﻳ ﻲﻧﺮﮕﻴﻣ دردﺮﺳ ﻲﺑﺎﻳزرا لﺎﻜﻴﻨﻴﻠﻛ يﺎﻫ هﺎﻣ ﻚﻳ رد ﻪﻠﻤﺣ زوﺮﺑ فﻼﺘﺧا دردﺮﺳ