Perioperative psycho-oncological intervention is associated with reduced psychological distress in women with breast and gynecological cancers: a prospective study.

Psychological distress is highly prevalent among patients with cancer, particularly during the perioperative period. Psycho-oncological interventions may improve emotional outcomes, yet their short-term effectiveness and moderating factors remain insufficiently explored. This prospective pre-post observational study without a control group included 95 women diagnosed with breast and gynecological cancers. Psychological assessments were conducted at baseline (T0) and after a perioperative psycho-oncological intervention (T1), consisting of 3-6 sessions integrating cognitive-behavioral therapy, mindfulness, narrative therapy, and guided imagery. Outcomes included anxiety (HAM-A), depression (HAM-D), post-traumatic stress symptoms (PCL), and self-esteem (RSES). Effect sizes (Cohen's d) and subgroup analyses were performed. Baseline scores indicated moderate to high levels of psychological distress. Significant improvements were observed across all psychological variables: anxiety (Δ = -7.6, d = 1.10), depression (Δ = -6.1, d = 0.98), PTSD symptoms (Δ = -8.8, d = 1.08), and self-esteem (Δ = +3.7, d = 0.85) (all P < 0.001). Clinical response rates ranged from 61% to 68%. Patients with insecure attachment showed higher baseline distress but greater improvement. Educational level, disease stage, and rural vs. urban origin influenced both baseline distress and treatment response. Short-term perioperative psycho-oncological intervention is associated with clinically significant reductions in psychological distress. Response variability suggests the need for personalized approaches based on psychological and socio-demographic profiles.