Comparison of Religious Cognitive Behavioral Therapy, Cognitive Behavioral Therapy, and Citalopram on Depression and Anxiety among Women with Breast Cancer: A Study Protocol for a Randomized Controlled Trial


  • Mazandaran University of Medical Sciences, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Sari, Iran, Islamic Republic of
  • Mazandaran University of Medical Sciences, Molecular and Cell Biology Research Center, Faculty of Medicine, Sari, Iran, Islamic Republic of
  • Mazandaran University of Medical Sciences, Department of Internal Medicine, Sari, Iran, Islamic Republic of
  • Behavioral Sciences Research Center, Department of Psychiatry Member of Psychiatry, Sari, Iran, Islamic Republic of
  • Mazandaran University of Medical Science, Department of Islamic Thought, Faculty of Medicine, Sari, Iran, Islamic Republic of
  • Mazandaran University of Medical Sciences, Department of Biostatistics, Health Sciences Research Center, Faculty of Health, Sari, Iran, Islamic Republic of
  • Iran University of Medical Sciences (IUMS), Mental Health Research Center (MHRC), Tehran Psychiatric Institute, Tehran, Iran, Islamic Republic of
  • Allame Tabatabai University, Faculty of Psychology and Educational Sciences, Tehran, Iran, Islamic Republic of
  • Mazandaran University of Medical Sciences, Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Sari, Iran, Islamic Republic of


There has been evidence supporting the reduction of depression and anxiety by religious psychotherapy in cancer patients, however, there have been scarce randomized controlled trials. Therefore, there is a need for replication in a well-designed study to investigate the efficacy of these interventions among depressed women with breast cancer. A randomized controlled trial is designed to be conducted on 160 women with breast cancer. Participants will be screened for anxiety and depression diagnosed by clinical interview based on the DSM-IV criteria and the Hospital Anxiety Depression Scale. Golriz and Baraheni's Religious Attitude Questionnaire will be used to assess the religious attitude. Individuals meeting the prerequisites will be randomly allocated to four groups, each containing 40 participants, including three intervention groups (RCBT, CBT, and citalopram) and one control group (usual breast cancer treatment). An instrument by the EORTCQLQ-C30 and BR-23 will be used to measure the quality of life. Blood tests will be taken to assess biomarkers with the (ELISA) method. The results will determine whether RCBT is more effective than other treatments. If so, the outcomes of the study will have implications not only for the management of similar problems in cancer patients but also for the management of other chronic diseases.


Anxiety, Biomarker, Breast Cancer, Citalopram, Cognitive Behavioral Therapy, Depression, Quality of Life, Religious Cognitive Behavioral Therapy

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