Pharmacological, psychosocial, and brain stimulation interventions in oncologic populations with mental disorders: An umbrella review

Mental health disorders frequently co-occur with oncological conditions, prompting an umbrella review(UR) to summarize meta-analytic evidence about the outcomes of pharmacological, psychosocial, and brain-stimulation interventions for psychiatric disorders in oncologic populations. We performed an UR of meta-analyses of randomized controlled trials(RCTs) documenting the efficacy of interventions for mental disorders in people with cancer(November 2, 2025). Re-calculated meta-analytic estimates employed the GRADE criteria for credibility. The AMSTAR-Plus Content Score was used to assess the quality of the meta-analyses. Overall, 82 meta-analyses(Number of records=111,331; primary studies=1,659) yielding 113 meta-analytic estimates were included. Five of 113 estimates were assigned a low level of certainty, and 108/113 were assigned a very low GRADE. Major depressive(55/113=48.67%) and any anxiety disorders(43/113=38.05%) emerged as the most frequently studied mental health diseases among the oncologic population. Mindfulness-based-stress-reduction for anxiety disorders in lung cancer was the only intervention significantly outperforming standard treatment(Hedges‘g=-1.46; 95%C.I.=-1.89;-1.04), whereas psychotherapy for women with breast cancer who underwent surgery was inferior to waiting list(in 80% of studies) in the treatment of anxiety due to women's body image post-mastectomy(G=0.33; 95%C.I.=0.14; 0.52), with relatively higher credibility compared to other outcomes. Meta-regression suggested that psychotherapies might benefit females more than men, and that age might differentially moderate larger and smaller effects of psychotherapies in advanced cancer and any cancer, respectively. While MBSR shows relatively higher-level evidence for anxiety disorders in the oncological population, the level of evidence is low, underscoring the need for further research on alternative treatment modalities. CBT should be part of anxiety management following mastectomy.