Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: A prospective study
Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: A prospective study
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DOI：
10.1002/pon.1057
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发表时间：
2007-03-01
期刊：
影响因子：
3.6
通讯作者：
Koch, Uwe
中科院分区：
文献类型：
--
作者：
Mehnert, Anja;Koch, Uwe
本研究的目的是确定急性和创伤后应激反应，共病精神障碍的乳腺癌患者。术后对127例患者（t1）进行了DSM-IV（SCID）的结构化临床访谈。在t1和6个月随访（t2）时，使用筛选措施评估创伤后应激反应、焦虑和抑郁。根据SCID，癌症相关ASD和PTSD的患病率均为2.4%。最常被描述为创伤性的经历是癌症诊断本身和随后的不确定感。终生PTSD患者（8.7%）更可能符合癌症相关ASD或PTSD的标准（OR = 14.1）。适应障碍的患病率估计为7.1%，重度抑郁症为4.7%，心境恶劣障碍为3.1%，广泛性焦虑障碍为6.3%。使用筛选工具，IES-R，PCL-C和HADS，我们发现PTSD在t1和t2分别为18.5%和11.2 - 16.3%。对焦虑和抑郁的估计显示，焦虑的发生率为39.6%（t1）和32.7%（t2），抑郁的发生率为16.0%（t1）和13.3%（t2）（0）（截止值>= 8）。在DSM-IV中，危及生命的疾病的诊断已被列为潜在的创伤。然而，必须严格评估主观的不确定感，如对治疗的恐惧，是否属于创伤性压力源，因此，PTSD的诊断是否适用于这组癌症患者。然而，大量的妇女与情绪困扰说明需要心理咨询和支持，在这个早期治疗阶段。版权所有（c）2006约翰威利父子有限公司。
This study aimed at the identification of acute and post-traumatic stress responses, and comorbid mental disorders in breast cancer patients. Structured clinical interviews for DSM-IV (SCID) were conducted post-surgery with 127 patients (t1). Screening measures were used to assess post-traumatic stress responses, anxiety, and depression at t1 and at 6 months follow-up (t2). Based on the SCID, prevalence rates were 2.4% for both, cancer-related ASD and PTSD. Experiences most frequently described as traumatic were the cancer diagnosis itself and subsequent feelings of uncertainty. Patients with lifetime PTSD (8.7%) were more likely to meet the criteria for cancer-related ASD or PTSD (OR = 14.1). Prevalence estimates were 7.1% for Adjustment Disorder, 4.7% for Major Depression, 3.1% for Dysthymic Disorder and 6.3% for Generalized Anxiety Disorder. Using the screening instruments, IES-R, PCL-C and HADS, we found PTSD in 18.5% at t1 and 11.2 - 16.3% at t2. The estimates of anxiety and depression reveal rates of 39.6% (t1) and 32.7% (t2) for anxiety, as well as 16.0% (t1) and 13.3% (t2) for depression (0) (cut-off >= 8). The diagnosis of a life-threatening illness has been included as a potential trauma in the DSM-IV. However, it has to be critically evaluated whether subjective feelings of uncertainty like fears of treatment count among traumatic stressors, and thus, whether the diagnosis of PTSD is appropriate in this group of cancer patients. However, a large number of women with emotional distress illustrate the need for psychosocial counseling and support in this early treatment phase. Copyright (c) 2006 John Wiley & Sons, Ltd.