Clinical correlates of suicidal thoughts in patients with advanced cancer.
Clinical correlates of suicidal thoughts in patients with advanced cancer.
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DOI：
10.1097/jgp.0b013e318233171a
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发表时间：
2012-04
期刊：
影响因子：
--
通讯作者：
Prigerson HG
中科院分区：
文献类型：
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作者：
Spencer RJ;Ray A;Pirl WF;Prigerson HG
癌症患者自杀的风险更高。对晚期癌症患者自杀意念的临床相关性进行了研究，以确定那些有风险的患者，并为制定干预措施以减少这一弱势群体的自杀意念提供信息。应对癌症（CwC）是一项由NCI和NIMH资助的多机构调查，旨在研究心理社会对晚期癌症患者生活质量和护理的影响。基线面对面的访谈，评估心理和身体功能，应对，精神和心理健康服务的使用进行了700例晚期癌症患者。与没有自杀意念的患者相比，8.9%报告有自杀想法的患者更可能是白色，并且报告没有与有组织的宗教信仰有关（p<0.05）。校正分析显示，符合当前惊恐障碍标准的癌症患者[校正OR（95%CI）3.24（1.01，10.4）]和创伤后应激障碍[3.97（1.13，14.1）]，获得精神卫生服务的人[3.70（2.07，6.67）]，特别是心理治疗[2.62（1.20，5.71）]、身体不适、缺乏自我效能感、缺乏灵性、缺乏被支持感的人比其他人更容易报告自杀念头（p<.05）。报告自杀想法的晚期癌症患者更有可能符合创伤后应激障碍和恐慌症的标准，感到不受支持，缺乏宗教信仰，精神和自我效能感，并经历更多的身体痛苦。姑息治疗干预措施，促进自我效能感，精神和支持，同时尽量减少身体痛苦，可能会提供减少自杀念头在这个高危群体的承诺。
Cancer patients are at heightened risk of suicide. Clinical correlates of suicidal ideation in advanced cancer patients were examined to identify those at risk and to inform the development of interventions to reduce suicidal ideation in this vulnerable group. Coping with Cancer (CwC) is an NCI- and NIMH-funded multi-institutional investigation examining psychosocial influences on the quality of life and care of advanced cancer patients. Baseline face-to-face interviews that assessed mental and physical functioning, coping, spirituality, and use of mental health services were conducted with 700 advanced cancer patients. Compared to patients without suicidal ideation, the 8.9% of patients who reported suicidal thoughts were more likely to be white and report no affiliation with an organized religion (p<.05). Adjusted analyses revealed that cancer patients who met criteria for current Panic Disorder [adjusted OR (95% CI) 3.24 (1.01, 10.4)] and Posttraumatic Stress Disorder [3.97 (1.13, 14.1)], who accessed mental health services [3.70 (2.07, 6.67)], particularly psychotherapy [2.62 (1.20,5.71) ], who were not feeling well physically, and who lacked a sense of self-efficacy, spirituality, and being supported were more likely than others to report thoughts of suicide (p<.05). Advanced cancer patients who report suicidal thoughts are more likely to meet criteria for posttraumatic stress disorder and panic disorder, feel unsupported, lack a religious affiliation, spirituality, and a sense of self-efficacy, and experience more physical distress. Palliative care interventions that promote a sense of self-efficacy, spirituality, and support while minimizing physical distress may offer promise for reducing suicidal thoughts in this at-risk group.