Distress, psychiatric morbidity, and prescriptions for psychotropic medication in a breast cancer waiting room sample
Distress, psychiatric morbidity, and prescriptions for psychotropic medication in a breast cancer waiting room sample
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DOI：
10.1016/j.genhosppsych.2003.08.012
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发表时间：
2004-03-01
影响因子：
7
通讯作者：
DeMichele, A
中科院分区：
文献类型：
--
作者：
Coyne, JC;Palmer, SC;DeMichele, A
我们研究了乳腺癌患者候诊室样本（N = 113）中精神病筛查、精神病发病率和精神病药物处方率之间的关系。抑郁症（29%）、重度抑郁症（MDD; 9%）和广泛性焦虑症（GAD; 6%）的发生率较低，与初级保健机构的发生率相似。相当大比例的患者（52%）在治疗期间接受过精神药物治疗，包括近一半（48%）目前没有精神病诊断的患者。大多数MDD患者在癌症治疗期间接受了药物治疗（80%），尽管只有一半的GAD患者接受了治疗。总体而言，高比率的精神药物对筛查的效率产生了负面影响，并且具有升高的痛苦的个体代表未经治疗的精神病发病率的可能性比新病例低约6倍。我们的结论是，乳腺癌所致精神病发病的风险可能较低，精神病发病的治疗率高于以前认为，筛查不太可能提供有效的识别未经治疗的精神病发病率。后续护理的准确性尚不清楚，药物可能会被非特异性地处方。未经治疗的精神病发病率较低可能表明需要多点合作，以产生足够数量的临床试验参与者。(C)2004年爱思唯尔公司All rights reserved.
We examined relationships among psychiatric screening, the prevalence of psychiatric morbidity, and prescription rates for psychotropic medication in a waiting room sample of breast cancer patients (N = 113). Rates of distress (29%), major depressive disorder (MDD; 9%), and generalized anxiety disorder (GAD; 6%) were low and similar to those found in primary care settings. A substantial proportion of patients (52%) had received psychotropic medication during treatment, including almost half (48%) of those without a current psychiatric diagnosis. Most individuals with MDD received pharmacotherapy during cancer treatment (80%), although only half of those with GAD were treated. Overall high rates psychotropic medication negatively impacted the efficiency of screening, and individuals with elevated distress were about 6 times less likely to represent a case of untreated psychiatric morbidity than to be a new case. We conclude that the risk of psychiatric morbidity attributable to breast cancer may be lower and treatment rates for psychiatric morbidity higher than previously believed and that screening is unlikely to provide efficient identification of untreated psychiatric morbidity. Adequacy of follow-up care is unclear and medication may be prescribed nonspecifically. The low rate of untreated psychiatric morbidity may signal a need for multisite collaborations to generate adequate numbers of participants in clinical trials. (C) 2004 Elsevier Inc. All rights reserved.