Effects of Tai Chi and Qigong in Depressive and Anxiety Symptoms in Cancer Patients: An Overview of Systematic Reviews

Abstract

Depressive and anxiety symptoms are prevalent among cancer patients, significantly impacting their quality of life and treatment adherence, which can lower survival rates. Addressing these symptoms with evidence-based interventions is crucial. Tai Chi and Qigong (TCQ) are popular complementary therapies that have shown potential in improving mental health in various populations, including cancer patients. However, systematic reviews (SRs) and meta-analyses have reported inconsistent findings regarding TCQ’s effectiveness in alleviating depressive and anxiety symptoms in cancer patients. An overview of these reviews can help synthesize outcomes, evaluate methodological quality, and clarify these discrepancies. The objective of this study was to identify and summarize the existing evidence regarding the effectiveness of TCQ in improving depressive and anxiety symptoms in cancer patients. Six electronic databases were searched from inception to July 2024. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Assessing the Methodological Quality of Systematic Reviews 2 was used to assess the methodological quality of the included SRs. In total, 894 studies were retrieved and assessed. Of these, 10 SRs were included, of which 9 SRs reported depressive symptoms and 8 SRs anxiety symptoms. Of these SRs, 5 out of 9 (56%) demonstrated significant improvement in depressive symptoms for TCQ with standardized mean differences (SMDs) ranging from −0.27 to −0.70, while 6 out of 8 (75%) demonstrated significant improvement in anxiety symptoms with SMDs ranging from −0.29 to −0.71. For quality appraisal, 1 SR was rated as high confidence, 3 SRs as moderate confidence, 2 SRs low confidence, and 4 SRs critically low confidence. After excluding 4 SRs with critically low confidence, 4 out of 5 (80%) of SRs demonstrated a significant effect of TCQ in improving depressive symptoms with SMDs ranging from −0.32 to −0.70, and all 6 SRs demonstrated significant improvement in anxiety symptoms with SMDs ranging from −0.29 to −0.71. TCQ can be effective in alleviating depressive and anxiety symptoms in cancer patients. Healthcare providers should consider incorporating TCQ into cancer care. More randomized controlled trials on various cancer sites (e.g., female genitals, lungs, brain, skin, and pancreas), cancer stages (e.g., Stage IV), and non-Chinese populations with longer follow-ups should be conducted.