Psychological rehabilitation of patients with colorectal cancer

AIM: to work out the program for psychological support for patients with colorectal cancer and to evaluate its efficiency.

PATIENTS AND METHODS: the prospective clinical psychological pilot study involved 26 patients who underwent surgery for colorectal cancer (after 6–12 months), aged 64.6 ± 7.1 year. The patients were divided into two groups: the main group included 12 patients who underwent psychotherapy and the control group with single consulting by the psychologist in order to fulfill the questionnaire (without psychotherapy). The psychological adjustment included cognitive behavioral psychotherapy and methods of neurofeedback. The efficiency assessment of the program for psychological adjustment was performed using the Hospital Anxiety and Depression Scale (HADS) before the rehabilitation and after its completion.

RESULTS: the primary diagnostics showed that the anxiety of all patients in both groups was increased up to the subclinical level (8.6 ± 0.5 and 8.7 ± 0.2 points). Most patients of both groups initially demonstrated depressive symptoms of various severity degrees (83.3% and 85.7%). After the psychological adjustment, the anxiety level of the patient of the main group was reduced from 8.6 ± 0.5 to 7.5 ± 0.3 points (p = 0.052). In the control group, the anxiety level practically did not change (8.7 ± 0.2 and 8.2 ± 0.6 points) (p = 0.436). The quantitative analysis of the testing results showed that after the adjustment course including psychotherapeutic measures the number of patients who did not have depression in the main group definitely increased (41.7%). In the control group, the number of patients with depression was reduced less significantly from 85.7% to 71.4%.

CONCLUSION: the anxiety-depressive condition is peculiar for patients with colorectal cancer 1 year after surgery and requires psychological support. The combination of cognitive behavioral psychotherapy and methods based on neurofeedback are effective psychological methods for these patients.

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