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Individual brief art therapy can be helpful for women with breast cancer: A randomized controlled clinical study

Published online by Cambridge University Press:  13 February 2009

Karin Egberg Thyme ,
Eva C. Sundin ,
Britt Wiberg ,
Inger Öster ,
Sture Åström  and
Jack Lindh
Karin Egberg Thyme*
Affiliation:
Department of Clinical Science, Psychiatry Umea University, Umea, Sweden
Eva C. Sundin
Affiliation:
Department of Clinical Science, Psychiatry Umea University, Umea, Sweden
Britt Wiberg
Affiliation:
Division of Psychology, Nottingham Trent University, Nottingham, United Kingdom
Inger Öster
Affiliation:
Department of Psychology, Umea University, Umea, Sweden
Sture Åström
Affiliation:
Department of Nursing, Umea University, Umea, Sweden
Jack Lindh
Affiliation:
Department of Radiation Sciences, Umea University, Umea, Sweden
*
Address correspondence and reprint requests to: Karin Egberg Thyme, Umea University, Department of Clinical Science, Psychiatry, SE-901 87 Umeå, Sweden. E-mail: [email protected]
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Abstract

Objective:

Recent research shows that almost every second woman with breast cancer is depressed or has anxiety; the risk for younger women is even higher. Moreover, research shows that women are at risk for developing depression, also a threat for women with breast cancer. The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy.

Methods:

The participants were between 37 and 69 years old; six participants in each group were below 50 years of age. Half of the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At the first measurement, at least 17% (n = 7) of the participants medicated with antidepressants. Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image (the Structural Analysis of Social Behaviour) and psychiatric symptoms (the Symptom Check List–90).

Results:

At follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The regression analysis showed that art therapy relates to lower ratings of depression, anxiety, and general symptoms; chemotherapeutic treatment predicts lower depressive symptoms; in contrast to axilliary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms.

Significance of results:

The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.

Keywords

Art therapyBreast cancerSymptom Check List–90 (SCL-90)Structural Analysis of Social Behaviour (SASB)Oncology
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 1 , March 2009 , pp. 87 - 95
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

American Psychiatric Association. (1994). Diagnostic and Statistical Manual (4th ed.). Washington, DC: Author.Google Scholar
Anzieu, D. (2000) Hudjaget. Stockholm: Natur och Kultur.Google Scholar
Badger, T.A., Braden, C.J., Mishel, M.H., et al. (2004). Depression burden, psychological adjustment and quality of life in women with breast cancer: Patterns power time. Research in Nursing & Health, 27, 19–28.CrossRefGoogle Scholar
Benjamin, L.S. (1974). Structural analysis of social behavior. Psychological Review, 81, 392–425.CrossRefGoogle Scholar
Betensky, M. (1995). What Do You See? London: Jessica Kingsley.Google Scholar
Björkenstam, C., Edberg, A., Ayoubi, S., et al. (2005). Are cancer patients at higher suicide risk than the general population? A nationwide register study in sweden from 1965 to 1999. Scandinavian Journal of public Healt, 33(3), 280–214.CrossRefGoogle Scholar
Borgmann, E. (2002). Art therapy with three women diagnosed with cancer. The Arts in Psychotherapy, 29, 245–251.CrossRefGoogle Scholar
Burgess, C., Cornelius, V., Love, S., et al. (2005). Depression and anxiety in women with early breast cancer; five year observational cohort study. British Medical Journal, 330, 702.CrossRefGoogle ScholarPubMed
Coombes, R.C., Hall, E., Gibson, L.J., et al. (2004). A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. New England Journal of Medicine, 350, 1081–1092.CrossRefGoogle ScholarPubMed
Derogatis, L.R., Lipman, R.S., & Covi, L. (1973). SCL-90: An outpatients psychiatric rating scale - A preliminary report. Psychopharmacological Bulletin, 9, 13–28.Google Scholar
Derogatis, L.R., Morrow, G.R., Fetting, D., et al. (1983). The prevalence of psychiatric disorders among cancer patients. JAMA, 249, 751–757.CrossRefGoogle ScholarPubMed
Edwards, B. (1987). Drawing on the Artist Within. New York: Fireside, Simon, & Schuster, Inc.Google Scholar
Egberg Thyme, K., Sundin, E.C., Lindström, B., et al. (2007 a). Förändringar av vestibulitsmärtor, psykiskt mående och välbefinnande samt upplevelser av själv och andra—en systematisk pilotstudie av sex unga kvinnor med vulva vestibulit som genomgått tidsbegränsad bildpsykoterapi. [Changes in pains of vulvar vestibulitis, psychical well-being, and perceived self and others—A pilot study of six women with vulvar vestibulitis who had art psychotherapy.] Matrix, 1, 49–72.Google Scholar
Egberg Thyme, K., Sundin, E.C., Ståhlberg, G., et al. (2007 b). The effect of short-term psychodynamic art therapy compared to short-term psychodynamic verbal therapy for women who are depressed. Psychoanalytic Psychotherapy, 3, 259–264.Google Scholar
Erikson, E. (1977). Toys and Reasons. New York: Norton.Google Scholar
Erikson, E. (1977). The Life Cycle Completed. New York: Norton.Google Scholar
Fridell, M., Cesarec, Z., Johansson, M., et al. (2002). Sv. Normering, standardisering och validering av symptomskalan SCL 90. (The Swedish Manual of the SCL-90) SIS: Rapport 4.Google Scholar
Gabriel, B., Bromberg, E., Vandenbovencamp, J., et al. (2001). Art therapy with adult bone marrow transplantation patients in isolation: A pilot study. Psycho-oncology, 19, 114–123.CrossRefGoogle Scholar
Giese-Davis, (2007). Assessing the Impact of Shame and Guilt in Retrived from http://med.stanford.edu/school/Psychiatry/Psychiatry/Cancerstudy.html#encode.Google Scholar
Glanz, K. & Lerman, C. (1992). Psychosocial impact of breast cancer: A critical review. Annals of Behavioral Medicine, 14, 204–212.Google Scholar
Hanson Frost, M., Suman, V.J., Rummans, T.A., et al. (2000). Physical, psychological and social well-being of women with breast cancer: The influence of disease face. Psycho-oncology 9, 221–231.3.0.CO;2-T>CrossRefGoogle Scholar
Helgeson, V.S., Snyder, P., & Seltman, H. (2004). Psychological and physical adjustment to breast cancer over 4 years: Identifying distinct trajectories of change. Health Psychology, 23, 3–15.CrossRefGoogle ScholarPubMed
Heywood, K. (2003). Introducing art therapy into the Christie Hospital Manchester UK 2001–2002. Complementary Therapies in Nursing & Midwifery, 9, 125–132.CrossRefGoogle ScholarPubMed
Hiltebrandt, E.U. (1999). Coping with cancer through image manipulation. In Medical Art therapy with Adults, Malchiodi, C. (Ed.), pp. 113–113. London: Jessica Kingsley Press.Google Scholar
Institute of Medicine (2004). Meeting Psychosocial Needs of Women with Breast Cancer. Washington, DC: The National Academies Press.Google Scholar
Jeanneau, M. & Armelius, K. (2000). Self-image and burnout in psychiatric staff. Journal of Psychiatric and Mental Health Nursing, 7, 399–406.CrossRefGoogle ScholarPubMed
Leichsenring, F., Rabung, S., & Leibing, E. (2004). The effect of short–term psychodynamic psychotherapy in specific psychiatric disorders. Archives of General Psychiatry, 61, 1208–1216.CrossRefGoogle ScholarPubMed
Lukowski, A.F., Wiebe, S.A., Haight, J.C., et al. (2005). Forming a stable memory representation in the first year of life: why imitation is more than child's play. Developmental Science, 8, (3), 279–298.CrossRefGoogle ScholarPubMed
Luzzatto, P. & Gabriel, B. (2000). The creative journey: A model for short-term group aet therapy with posttreatment cancer patients. Art Therapy: A Journal of the American Art Therapy Association, 17, 265–269.CrossRefGoogle Scholar
Luzzatto, P., Sereno, V., & Capps, R. (2003). A communication tool for cancer patients with pain: The art therapy technique of the body outline. Palliative and Supportive Care, 1, 135–142.CrossRefGoogle ScholarPubMed
Malchiodi, C. (Ed.). (1999). Medical Art Therapy with Adults. London: Jessica Kingsley Publishers.Google Scholar
McDougall, J. (1989). The Theatres of the Body. London: Free Association Books.Google Scholar
Minar, V.M. (1999). Art therapy and cancer: Images of the hurt and healer. In Medical Art Therapy with Adults, Malchiodi, C. (Ed.), pp. 227–242. London: Jessica Kingsley Press.Google Scholar
Monti, D.A., Peterson, C., Shakin Kunkel, E.J., et al. (2006). A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer. Psycho-oncology, 15, 363–373.CrossRefGoogle ScholarPubMed
Mosher, C.E. & Danoff-Burg, S. (2005). A review of age differences in psychological adjustment to breast cancer. Journal of Psychosocial Oncology, 23, 101–114.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999). Explaining the gender difference in depressive symptoms. Journal of Personality and Social Psychology, 77, 1061–1072.CrossRefGoogle ScholarPubMed
Öster, I., Magnusson, E., Egberg Thyme, K., et al. (2007). Art therapy for women with breast cancer: The therapeutic consequences of boundary strengthening. The Arts in Psychotherapy, 34, 277–288.CrossRefGoogle Scholar
Öster, I., Åström, S., Lindh, J. & Magnusson, E. (2008). Women with breast cancer and gendered limits and boundaries - art therapy as a “safe space” for enacting alternative subject positions. The Arts in Psychotherapy. http://dx.doi.org/10.1016/j.aip.2008.10.001.CrossRefGoogle Scholar
Postone, N. (1998). Psychotherapy with cancer patients. American Journal of Psychotherapy, 52, 412–424.CrossRefGoogle ScholarPubMed
Pratt, M. & Wood, M.J. (1998). Art Therapy in Palliative Care. London: Routledge.Google Scholar
Rusted, J., Sheppard, L., & Waller, D. (2002). Art therapy improves social functioning and communication in people with dementia. Neurology of Ageing, 23:1, Abstract No. 197.Google Scholar
Schaverien, J. (1992). The Revealing Image. London: Routledge.Google Scholar
Scheier, M.F., Helgeson, V.S., Schultz, R., et al. (2005). Interventions to enhance physical and psychological functioning among younger women who are ending nonhormonal adjuvant treatment for early-stage breast cancer. Journal of Clinical Oncology, 23, 4298–4311.CrossRefGoogle ScholarPubMed
Singletary, S.E. & Connolly, J.L. (2006). Breast cancer staging: Working with the sixth edition of the AJCC cancer staging manual. CA: A Cancer Journal for Clinicians, 56, 37–47.Google ScholarPubMed
Spiegel, D. (1994). Health caring. Psychosocial support for patient with cancer. Cancer, 74, 1453–1456.3.0.CO;2-1>CrossRefGoogle Scholar
Spiegel, D. (1997). Psychosocial aspects of breast cancer treatment. Seminars of Oncology, 24, S1-36–S1-47.Google ScholarPubMed
Spiegel, D., Bloom, J.R., Kraemer, H.C., et al. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888–891.CrossRefGoogle ScholarPubMed
Sugerman, A. (2006). Mentalization, insightfulness, and therapeutic action. International Journal of Psychoanalysis, 87, 965–987.CrossRefGoogle Scholar
Suzuki, N. (2004). Complementary and alternative medicine: A Japanese perspective. Evident-based Complementary and Alternative Medicine, 1, 113–118.CrossRefGoogle ScholarPubMed
Swedish Organised Service Screening Evaluation Group. (2006). Reduction in breast cancer mortality from organized service screening with mammography. I. Further confirmation with extended data. Cancer Epidemiology Biomarkers & Prevention, 15, 45–51.CrossRefGoogle Scholar
Üstün, T.B., Ayuso-Mateos, J.L., Chatterji, S., et al. (2004). Global burden of depressive disorders in the year 2000. British Journal of Psychiatry, 184, 386–392.CrossRefGoogle ScholarPubMed
Winnicott, D.W. (1971). Playing and Reality. London: Tavistock.Google Scholar
Wong-Kim, E.C. & Bloom, J.R. (2005). Depression experienced by young women newly diagnosed with breast cancer. Psycho-oncology, 14, 564–573.CrossRefGoogle ScholarPubMed
Yousaf, U., Christensen, M.L., Engholm, G., et al. (2005). Suicides among Danish cancer patients 1971–1999. British Journal of Cancer Care, 2, 107–111.Google Scholar