Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria

Vitalis Okwor; Chioma Asuzu; Maria Onyedibe; Chika Okwor; Udemba Chijioke; Jude Ede; Stephen Musayayi; Augustine Onuh; Jane Nnabuchi

doi:doi:10.11648/j.cmr.20261504.11

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| Peer-Reviewed

Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria

Vitalis Okwor

, Chioma Asuzu

, Maria Onyedibe

, Chika Okwor^*

, Udemba Chijioke

, Jude Ede, Stephen Musayayi

, Augustine Onuh, Jane Nnabuchi

Published in Clinical Medicine Research (Volume 15, Issue 4)

Received: 24 August 2026 Accepted: 14 September 2026 Published: 28 September 2026

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Abstract

Depression is common among patients diagnosed with advanced or metastatic breast cancer (BC), with the diagnosis often associated with severe emotional and psychological decline that may result from the disease or from treatment-related toxicity. Cognitive Behavioral Therapy (CBT) has emerged as one of the most evidence-based and effective psychotherapeutic approaches for the management of depression and anxiety in cancer populations but its implementation, use and role in the management of depression among advanced BC patients in low resource settings remains limited. Therefore, this study aimed to evaluate the effectiveness of CBT in reducing depressive symptoms among patients with advanced breast cancer patients receiving treatment at the University of Nigeria Teaching Hospital, Enugu. This study investigated the role of a six (6) week group CBT on depression among advanced BC patients. The study adopted randomized controlled Pre-test Post-test design. Forty two (42) advanced breast cancer patients were randomly divided into two groups: CBT group (n= 20) and control group (n= 22). The CBT group received a 6 week, 90 minutes CBT sessions once a week and the control group only received their cancer treatment and patient navigation assistance. Assessment was carried out for both groups at baseline (Pre-test) and the intervention. A total of BC patients were accessed for depression of which 42 patients recruited and 27 patients completed the study. Baseline assessment of participants showed mean depression scores of 12.05 ± 1.61 for CBT group and 12.77 ± 1.95 for the control groups (p=0.20). Post intervention assessment result showed that participants in the CBT group reported a significantly greater decrease in depression (3.50 ± 0.94) compared to participants in the control group (13.23 ± 1.78) (p<0.001). Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Implementing CBT into practice may appear challenging at first, but efforts to help these patients in achieving better all-around health are efforts well spent.

Published in	Clinical Medicine Research (Volume 15, Issue 4)
DOI	10.11648/j.cmr.20261504.11
Page(s)	52-59
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

Breast Cancer, Cognitive Behavioral Therapy, Depression

References

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APA Style

Okwor, V., Asuzu, C., Onyedibe, M., Okwor, C., Chijioke, U., et al. (2026). Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria. Clinical Medicine Research, 15(4), 52-59. https://doi.org/10.11648/j.cmr.20261504.11

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ACS Style

Okwor, V.; Asuzu, C.; Onyedibe, M.; Okwor, C.; Chijioke, U., et al. Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria. Clin. Med. Res. 2026, 15(4), 52-59. doi: 10.11648/j.cmr.20261504.11

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AMA Style

Okwor V, Asuzu C, Onyedibe M, Okwor C, Chijioke U, et al. Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria. Clin Med Res. 2026;15(4):52-59. doi: 10.11648/j.cmr.20261504.11

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@article{10.11648/j.cmr.20261504.11,
  author = {Vitalis Okwor and Chioma Asuzu and Maria Onyedibe and Chika Okwor and Udemba Chijioke and Jude Ede and Stephen Musayayi and Augustine Onuh and Jane Nnabuchi},
  title = {Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria},
  journal = {Clinical Medicine Research},
  volume = {15},
  number = {4},
  pages = {52-59},
  doi = {10.11648/j.cmr.20261504.11},
  url = {https://doi.org/10.11648/j.cmr.20261504.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20261504.11},
  abstract = {Depression is common among patients diagnosed with advanced or metastatic breast cancer (BC), with the diagnosis often associated with severe emotional and psychological decline that may result from the disease or from treatment-related toxicity. Cognitive Behavioral Therapy (CBT) has emerged as one of the most evidence-based and effective psychotherapeutic approaches for the management of depression and anxiety in cancer populations but its implementation, use and role in the management of depression among advanced BC patients in low resource settings remains limited. Therefore, this study aimed to evaluate the effectiveness of CBT in reducing depressive symptoms among patients with advanced breast cancer patients receiving treatment at the University of Nigeria Teaching Hospital, Enugu. This study investigated the role of a six (6) week group CBT on depression among advanced BC patients. The study adopted randomized controlled Pre-test Post-test design. Forty two (42) advanced breast cancer patients were randomly divided into two groups: CBT group (n= 20) and control group (n= 22). The CBT group received a 6 week, 90 minutes CBT sessions once a week and the control group only received their cancer treatment and patient navigation assistance. Assessment was carried out for both groups at baseline (Pre-test) and the intervention. A total of BC patients were accessed for depression of which 42 patients recruited and 27 patients completed the study. Baseline assessment of participants showed mean depression scores of 12.05 ± 1.61 for CBT group and 12.77 ± 1.95 for the control groups (p=0.20). Post intervention assessment result showed that participants in the CBT group reported a significantly greater decrease in depression (3.50 ± 0.94) compared to participants in the control group (13.23 ± 1.78) (p<0.001). Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Implementing CBT into practice may appear challenging at first, but efforts to help these patients in achieving better all-around health are efforts well spent.},
 year = {2026}
}

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TY  - JOUR
T1  - Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria
AU  - Vitalis Okwor
AU  - Chioma Asuzu
AU  - Maria Onyedibe
AU  - Chika Okwor
AU  - Udemba Chijioke
AU  - Jude Ede
AU  - Stephen Musayayi
AU  - Augustine Onuh
AU  - Jane Nnabuchi
Y1  - 2026/09/28
PY  - 2026
N1  - https://doi.org/10.11648/j.cmr.20261504.11
DO  - 10.11648/j.cmr.20261504.11
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 52
EP  - 59
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20261504.11
AB  - Depression is common among patients diagnosed with advanced or metastatic breast cancer (BC), with the diagnosis often associated with severe emotional and psychological decline that may result from the disease or from treatment-related toxicity. Cognitive Behavioral Therapy (CBT) has emerged as one of the most evidence-based and effective psychotherapeutic approaches for the management of depression and anxiety in cancer populations but its implementation, use and role in the management of depression among advanced BC patients in low resource settings remains limited. Therefore, this study aimed to evaluate the effectiveness of CBT in reducing depressive symptoms among patients with advanced breast cancer patients receiving treatment at the University of Nigeria Teaching Hospital, Enugu. This study investigated the role of a six (6) week group CBT on depression among advanced BC patients. The study adopted randomized controlled Pre-test Post-test design. Forty two (42) advanced breast cancer patients were randomly divided into two groups: CBT group (n= 20) and control group (n= 22). The CBT group received a 6 week, 90 minutes CBT sessions once a week and the control group only received their cancer treatment and patient navigation assistance. Assessment was carried out for both groups at baseline (Pre-test) and the intervention. A total of BC patients were accessed for depression of which 42 patients recruited and 27 patients completed the study. Baseline assessment of participants showed mean depression scores of 12.05 ± 1.61 for CBT group and 12.77 ± 1.95 for the control groups (p=0.20). Post intervention assessment result showed that participants in the CBT group reported a significantly greater decrease in depression (3.50 ± 0.94) compared to participants in the control group (13.23 ± 1.78) (p<0.001). Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Implementing CBT into practice may appear challenging at first, but efforts to help these patients in achieving better all-around health are efforts well spent.
VL  - 15
IS  - 4
ER  -

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Author Information

Vitalis Okwor

Department of Radiation and Clinical Oncology, University of Nigeria Teaching Hospital, Enugu, Nigeria

http://orcid.org/0000-0002-9821-4140
Chioma Asuzu

Department of Counseling and Human Development Studies, University of Ibadan, Ibadan, Nigeria

http://orcid.org/0000-0002-9975-2928
Maria Onyedibe

Department of Psychology, University of Nigeria, Nsukka, Nigeria

http://orcid.org/0000-0001-9493-1495
Chika Okwor

Department of Chemical Pathology, University of Nigeria Enugu Campus, Enugu, Nigeria

Contact Email

http://orcid.org/0000-0002-1106-6668
Udemba Chijioke

Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria

http://orcid.org/0009-0007-2800-7473
Jude Ede

Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria
Stephen Musayayi

College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria

http://orcid.org/0009-0003-0406-911X
Augustine Onuh

Department of Radiation Medicine, University of Nigeria Ituku/Ozalla, Enugu, Nigeria
Jane Nnabuchi

Federal Neuropychiatric Hospital, Enugu, Nigeria

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APA Style

Okwor, V., Asuzu, C., Onyedibe, M., Okwor, C., Chijioke, U., et al. (2026). Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria. Clinical Medicine Research, 15(4), 52-59. https://doi.org/10.11648/j.cmr.20261504.11

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ACS Style

Okwor, V.; Asuzu, C.; Onyedibe, M.; Okwor, C.; Chijioke, U., et al. Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria. Clin. Med. Res. 2026, 15(4), 52-59. doi: 10.11648/j.cmr.20261504.11

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AMA Style

Okwor V, Asuzu C, Onyedibe M, Okwor C, Chijioke U, et al. Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria. Clin Med Res. 2026;15(4):52-59. doi: 10.11648/j.cmr.20261504.11

Copy | Download

@article{10.11648/j.cmr.20261504.11,
  author = {Vitalis Okwor and Chioma Asuzu and Maria Onyedibe and Chika Okwor and Udemba Chijioke and Jude Ede and Stephen Musayayi and Augustine Onuh and Jane Nnabuchi},
  title = {Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria},
  journal = {Clinical Medicine Research},
  volume = {15},
  number = {4},
  pages = {52-59},
  doi = {10.11648/j.cmr.20261504.11},
  url = {https://doi.org/10.11648/j.cmr.20261504.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20261504.11},
  abstract = {Depression is common among patients diagnosed with advanced or metastatic breast cancer (BC), with the diagnosis often associated with severe emotional and psychological decline that may result from the disease or from treatment-related toxicity. Cognitive Behavioral Therapy (CBT) has emerged as one of the most evidence-based and effective psychotherapeutic approaches for the management of depression and anxiety in cancer populations but its implementation, use and role in the management of depression among advanced BC patients in low resource settings remains limited. Therefore, this study aimed to evaluate the effectiveness of CBT in reducing depressive symptoms among patients with advanced breast cancer patients receiving treatment at the University of Nigeria Teaching Hospital, Enugu. This study investigated the role of a six (6) week group CBT on depression among advanced BC patients. The study adopted randomized controlled Pre-test Post-test design. Forty two (42) advanced breast cancer patients were randomly divided into two groups: CBT group (n= 20) and control group (n= 22). The CBT group received a 6 week, 90 minutes CBT sessions once a week and the control group only received their cancer treatment and patient navigation assistance. Assessment was carried out for both groups at baseline (Pre-test) and the intervention. A total of BC patients were accessed for depression of which 42 patients recruited and 27 patients completed the study. Baseline assessment of participants showed mean depression scores of 12.05 ± 1.61 for CBT group and 12.77 ± 1.95 for the control groups (p=0.20). Post intervention assessment result showed that participants in the CBT group reported a significantly greater decrease in depression (3.50 ± 0.94) compared to participants in the control group (13.23 ± 1.78) (p<0.001). Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Implementing CBT into practice may appear challenging at first, but efforts to help these patients in achieving better all-around health are efforts well spent.},
 year = {2026}
}

Copy | Download

TY  - JOUR
T1  - Effectiveness of Cognitive Behavioral Therapy in the Management of Depression among Patients with Advanced Breast Cancer in South-Eastern Nigeria
AU  - Vitalis Okwor
AU  - Chioma Asuzu
AU  - Maria Onyedibe
AU  - Chika Okwor
AU  - Udemba Chijioke
AU  - Jude Ede
AU  - Stephen Musayayi
AU  - Augustine Onuh
AU  - Jane Nnabuchi
Y1  - 2026/09/28
PY  - 2026
N1  - https://doi.org/10.11648/j.cmr.20261504.11
DO  - 10.11648/j.cmr.20261504.11
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 52
EP  - 59
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20261504.11
AB  - Depression is common among patients diagnosed with advanced or metastatic breast cancer (BC), with the diagnosis often associated with severe emotional and psychological decline that may result from the disease or from treatment-related toxicity. Cognitive Behavioral Therapy (CBT) has emerged as one of the most evidence-based and effective psychotherapeutic approaches for the management of depression and anxiety in cancer populations but its implementation, use and role in the management of depression among advanced BC patients in low resource settings remains limited. Therefore, this study aimed to evaluate the effectiveness of CBT in reducing depressive symptoms among patients with advanced breast cancer patients receiving treatment at the University of Nigeria Teaching Hospital, Enugu. This study investigated the role of a six (6) week group CBT on depression among advanced BC patients. The study adopted randomized controlled Pre-test Post-test design. Forty two (42) advanced breast cancer patients were randomly divided into two groups: CBT group (n= 20) and control group (n= 22). The CBT group received a 6 week, 90 minutes CBT sessions once a week and the control group only received their cancer treatment and patient navigation assistance. Assessment was carried out for both groups at baseline (Pre-test) and the intervention. A total of BC patients were accessed for depression of which 42 patients recruited and 27 patients completed the study. Baseline assessment of participants showed mean depression scores of 12.05 ± 1.61 for CBT group and 12.77 ± 1.95 for the control groups (p=0.20). Post intervention assessment result showed that participants in the CBT group reported a significantly greater decrease in depression (3.50 ± 0.94) compared to participants in the control group (13.23 ± 1.78) (p<0.001). Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Implementing CBT into practice may appear challenging at first, but efforts to help these patients in achieving better all-around health are efforts well spent.
VL  - 15
IS  - 4
ER  -

Copy | Download