Onset and relapse of psychiatric disorders following early breast cancer: a case-control study
Onset and relapse of psychiatric disorders following early breast cancer: a case-control study
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DOI：
10.1002/pon.1469
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发表时间：
2009-10-01
期刊：
影响因子：
3.6
通讯作者：
Chaudieu, Isbelle
中科院分区：
文献类型：
--
作者：
Gandubert, Catherine;Carriere, Isabelle;Chaudieu, Isbelle
目的：我们的目的是根据DSM-IV标准评估原发性早期乳腺癌幸存者的精神状态，区分癌症诊断后开始的新精神诊断与复发。方法：对144名乳腺癌幸存者和125名无癌症病史的女性进行比较研究。通过标准化的精神病学检查（迷你国际神经精神病学访谈，沃森创伤后应激障碍量表），在三个连续的时期对神经精神症状进行回顾性评估，“癌症前”（从童年到访谈前3年），“癌症事件前后”（最近3年包括诊断和治疗的时间）和“当前”（最近2周）。结果：与对照组（广泛性焦虑症（GAD）和重度抑郁症（MDD））相比，乳腺癌诊断后观察到焦虑和情绪障碍的发生率增加；10.4 vs 1.6%, 19.4 vs 8.8%)。癌症疾病促进了精神障碍（n = 4例新发病例/6例2年流行病例）和PTSD（7/7）的发展，以及重度抑郁症（n = 21例复发/28例3年流行病例）和广泛性焦虑症（10115例）的再次出现。在癌症手术后超过1.75年（中位时间），访谈时未报告严重情绪障碍如重度抑郁症（16.0%对7.2%）和心境恶劣（4.2%对0%）的改善，乳腺癌幸存者的患病率是对照组的2-4倍。结论：尽管治疗取得了重大进展，但乳腺癌的诊断与各种形式的精神病理高度相关，无论精神病史如何，治疗后症状持续存在。这些结果可能有助于临床医生为患有乳腺癌的妇女制定心理保健计划。版权所有John Wiley & Sons， Ltd. 2009
Objective: Our objective is to evaluate the mental status of primary early breast cancer survivors according to DSM-IV criteria, distinguishing new psychiatric diagnosis, which started after the cancer diagnosis from relapse.Methods: A comparative study of 144 breast cancer survivors and 125 women without previous history of cancer was carried out. Neuropsychiatric symptomatology was assessed retrospectively using standardized psychiatric examinations (Mini International Neuropsychiatric Interview, Watson's Post-Traumatic Stress Disorder Inventory) over three successive periods, 'before cancer' (from childhood to 3 years before the interview), 'around the cancer event' (the last 3 years including the time of diagnosis and treatment), and 'currently' (the last 2 weeks).Results: Increased rates of anxiety and mood disorders were observed following a diagnosis of breast cancer compared with controls (generalized anxiety disorder (GAD) and major depressive disorder (MDD); 10.4 vs 1.6% and 19.4 vs 8.8%, respectively). The cancer disease promoted the development of dysthymia (n = 4 new cases/6 two-year prevalent cases) and PTSD (7/7) and the re-emergence of MDD (n = 21 relapses/28 three-year prevalent cases) and GAD (10115). No improvement in serious mood disorders such as MDD (16.0 vs 7.2%) and dysthymia (4.2 vs 0%) was reported at the time of interview, more than 1.75 years (median time) after the cancer surgery, the prevalence being 2-4 times greater in breast cancer survivors than in controls.Conclusion: Despite significant advances in treatment, a diagnosis of breast cancer is highly associated with various forms of psychopathology, regardless of psychiatric history, with symptoms persisting after treatment. These results may assist clinicians in planning mental healthcare for women with breast cancer. Copyright (C) 2009 John Wiley & Sons, Ltd.