First Anxiety, Afterwards Depression: Psychological Distress in Cancer Patients at Diagnosis and after Medical Treatment
First Anxiety, Afterwards Depression: Psychological Distress in Cancer Patients at Diagnosis and after Medical Treatment
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DOI：
10.1002/smi.2445
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发表时间：
2012-12-01
影响因子：
4.1
通讯作者：
Benito, Llucia
中科院分区：
文献类型：
--
作者：
Gil, Francisco;Costa, Gema;Benito, Llucia
目的 本研究的目的是评估两个特定时刻的心理社会变化：癌症诊断时和完成治疗后 24 周。材料和方法 本研究共对 67 名癌症门诊患者进行了评估。纳入/排除标准如下：年龄18岁或以上并接受治疗的门诊癌症患者。排除表现状态 = Pfeiffer 问卷中有 3 个错误的患者。纳入时间范围为2005年4月1日至2007年4月30日。使用的量表为14项医院焦虑和抑郁量表（HADS），其中包括焦虑（7个项目）和抑郁（7个项目）两个子量表、生活质量简表36问卷、心理调整量表和用于衡量社会支持的医疗结果研究问卷。所有数据均与社会人口统计学和医学特征进行比较。 结果 与治疗后相比，患者治疗前的焦虑水平较高（HADS-焦虑平均值，7.41 vs 6.69），而治疗后抑郁评分高于治疗前（HADS-抑郁平均值，3.14 vs 3.89）。治疗后，患者更加疲劳，表现状态较低（卡诺夫斯基指数），社会支持较少，生活质量较差，但应对方式没有差异。女性的焦虑程度高于男性。有精神病史的患者的痛苦程度较高，但这些差异仅在诊断后而非治疗后观察到。一般来说，头颈癌患者的痛苦程度更高，应对能力更差，社会功能更差。结论癌症患者在治疗前后需要特别考虑。焦虑是诊断的特征症状，而抑郁症在治疗后更为常见。头颈癌患者是复杂性最高的群体。版权所有 (C) 2012 约翰·威利父子有限公司
Objective The purpose of this study was to assess psychosocial changes at two particular moments: at cancer diagnosis and 24 weeks after having finished treatment.Material and methods A total of 67 cancer outpatients were assessed in this study. The inclusion/exclusion criteria were as follows: ambulatory cancer patients aged 18 years or older and receiving medical treatment. Patients with a performance status = 3 errors in the Pfeiffer Questionnaire) were excluded. The inclusion period ranged from 1 April 2005 to 30 April 2007. The scales used were the 14-item Hospital Anxiety and Depression Scale (HADS), which has two subscales for anxiety (seven items) and for depression (seven items), the Quality of Life Short Form 36 Questionnaire, the Mental Adjustment Scale and the Medical Outcomes Study Questionnaire for measuring social support. All data were compared with sociodemographic and medical characteristics.Results Patients had higher levels of pre-treatment versus post-treatment anxiety (HADS-Anxiety mean, 7.41 versus 6.69), whereas depression scores were higher post-treatment versus pre-treatment (HADS-Depression mean, 3.14 versus 3.89). After medical treatment, patients were more fatigued, with lower performance status (Karnofsky Index), less social support and less quality of life, but no differences in coping styles were found. Women had higher levels of anxiety than men. Patients with psychiatric antecedents had higher levels of distress, but these differences were only observed after diagnosis and not after the treatment. In general, head and neck cancer patients had higher levels of distress, worse coping and worse social functioning.Conclusions Cancer patients require special consideration before and after treatment. Anxiety is the symptom that characterizes diagnosis, whereas depression is more common after medical treatment. The head and neck cancer patients were the group with the highest complexity. Copyright (C) 2012 John Wiley & Sons, Ltd.