Prevalence and Predictors of the Short-Term Trajectory of Anxiety and Depression in the First Year After a Cancer Diagnosis: A Population-Based Longitudinal Study
Prevalence and Predictors of the Short-Term Trajectory of Anxiety and Depression in the First Year After a Cancer Diagnosis: A Population-Based Longitudinal Study
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DOI：
10.1200/jco.2012.44.7540
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发表时间：
2013-07-20
影响因子：
45.3
通讯作者：
Carey, Mariko L.
中科院分区：
文献类型：
--
作者：
Boyes, Allison W.;Girgis, Afaf;Carey, Mariko L.
研究目的：很少有研究探讨癌症幸存者在治疗后期和早期的心理适应。我们的研究调查的患病率和短期轨迹的焦虑，抑郁症，共病的焦虑抑郁症的成年癌症幸存者，并确定个人，疾病，健康行为，心理和社会的预测慢性和晚期心理morphology.MethodsA异质样本的成年癌症幸存者被招募两个国家为基础的癌症登记处。共有1,154名幸存者在诊断后6个月（时间1）和12个月（时间2）完成了自我报告问卷。采用医院焦虑和抑郁量表评估焦虑和抑郁，以子量表临界评分>= 8分确定病例。Logistic回归分析发现时间1特征与时间2的焦虑和/或抑郁相关。结果焦虑（时间1，22%;时间2，21%）、抑郁（两个时间点均为13%）和焦虑抑郁共病（两个时间点均为9%）的时点患病率在诊断后6个月和12个月相似。最常见的时间1至时间2轨迹是焦虑（70%）、抑郁（82%）和焦虑抑郁共病（87%）的非病例。虽然心理发病率在时间1是最强的预测心理发病率在时间2，被诊断为肺癌和健康风险行为（吸烟，体力活动不足）也是强predictors.ConclusionTargeted心理筛查的脆弱的幸存者和早期干预，可以防止发病和/或降低心理发病率的严重程度在早期生存。针对心理功能和健康风险行为的风险降低干预试验似乎是必要的。(C)2013年美国临床肿瘤学会
PurposeFew studies have examined psychological adjustment for cancer survivors in late treatment and early survivorship stages. Our study investigated the prevalence and short-term trajectories of anxiety, depression, and comorbid anxiety-depression among adult cancer survivors, and identified the individual, disease, health behavior, psychological, and social predictors of chronic and late psychological morbidity.MethodsA heterogeneous sample of adult cancer survivors was recruited from two state-based cancer registries. A total of 1,154 survivors completed self-report questionnaires at 6 (Time 1) and 12 months (Time 2) postdiagnosis. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale with cases identified by a subscale cutoff score >= 8. Logistic regression analyses identified Time 1 characteristics associated with anxiety and/or depression at Time 2.ResultsThe point prevalence of anxiety (Time 1, 22%; Time 2, 21%), depression (13% at both timepoints) and comorbid anxiety-depression (9% at both timepoints) was similar at 6 and 12 months postdiagnosis. The most prevalent Time 1 to Time 2 trajectory was noncase for anxiety (70%), depression (82%), and comorbid anxiety-depression (87%). While psychological morbidity at Time 1 was the strongest predictor of psychological morbidity at Time 2, being diagnosed with lung cancer and health risk behaviors (smoking, insufficient physical activity) were also strong predictors.ConclusionTargeted psychological screening of vulnerable survivors and early intervention may prevent the onset and/or reduce the severity of psychological morbidity in early survivorship. Trials of risk reduction interventions targeting psychological functioning and health risk behaviors seem warranted. (C) 2013 by American Society of Clinical Oncology