[Comorbid psychiatric disorders in cancer patients in acute inpatient treatment and medical rehabilitation].
[Comorbid psychiatric disorders in cancer patients in acute inpatient treatment and medical rehabilitation].
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癌症患者急性住院治疗和医疗康复中合并精神疾病的研究[J].
DOI：
10.1055/s-2000-8948
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
J. Weis
中科院分区：
文献类型：
--
作者：
M. Härter;K. Reuter;B. Schretzmann;A. Hasenburg;A. Aschenbrenner;J. Weis
许多针对住院患者的临床研究报告了精神障碍（尤其是情感障碍和焦虑障碍）与癌症之间的关联。然而，没有关于德国接受癌症急症护理或康复治疗的患者精神障碍患病率的数据。本研究调查了癌症合并症精神障碍的 4 周、6 个月和终生患病率。使用标准化筛查量表对来自 2 个康复诊所和 2 个急症护理医院的 256 名患者进行了心理负担 (GHQ-12、HADS) 和生活质量 (SF-36) 的检查。通过主治肿瘤科医生的标准化医疗记录评估躯体参数和干预措施。在第二阶段检查中，对 120 名患者的子样本进行了标准化临床访谈 (CIDI) 访谈，以获得精神障碍的 DSM-IV 诊断。 44%（急性护理）和 49%（康复）的患者具有较高 GHQ 评分（截止值 > 4）。此外，超过 20% 的癌症患者在 HADS 抑郁和焦虑分量表上的得分较高（截止值 > 或 = 11）。康复样本中精神障碍的患病率在 4 周内为 34%（相比之下，急性护理样本中为 24%），6 个月期间为 45%（相对于 38%），终生为 79%（相比之下，急性护理样本中为 49%）。当前最常见的疾病是情感障碍（康复障碍占 13%，急性护理障碍占 11%）和焦虑障碍（两个样本中均为 17%）。 The rates of affective and anxiety disorders are much higher than the frequency of these disorders in recent epidemiological studies of the normal population in Germany.患者所表现出的高社会心理负担以及抑郁症和焦虑症的发生频率强调了以下方面的重要性：(1) 识别精神障碍的有效诊断策略；(2) 肿瘤学专业心理社会服务，为癌症患者的急症护理和康复提供心理支持和有效干预措施。
An association between mental disorders, especially affective and anxiety disorders, and cancer has been reported in many clinical studies with inpatients. However, no data exist about the prevalence of mental disorders in patients undergoing acute care or rehabilitation treatment for cancer in Germany. The present study investigated 4-week, 6-month and lifetime prevalence rates of comorbid mental disorders in cancer. 256 patients from 2 rehabilitation clinics and 2 acute care hospitals were examined with standardized screening scales for psychological burden (GHQ-12, HADS) and quality of life (SF-36). Somatic parameters and interventions were assessed through standardized medical records from the attending oncologists. In the second-stage examination a subsample of 120 patients were interviewed with standardized clinical interview (CIDI) in order to obtain DSM-IV diagnoses of mental disorders. 44% (acute care) and 49% (rehabilitation) of the patients have high GHQ scores (cut-off > 4). Furthermore, more than 20% of the cancer patients have elevated scores on the HADS subscales depression and anxiety (cut-off > or = 11). Prevalence rates of mental disorders in the rehabilitation sample are 34% for the 4-week (vs. 24% in the acute care sample), 45% for the 6-month period (vs. 38%), and 79% for lifetime (vs. 49% in the acute care sample). The most frequent current disorders are affective (13% rehabilitation vs. 11% acute care) and anxiety disorders (17% in both samples). The rates of affective and anxiety disorders are much higher than the frequency of these disorders in recent epidemiological studies of the normal population in Germany. The high psychosocial burden expressed by the patients and the frequency of depressive and anxiety disorders emphasize the importance of (1) effective diagnostic strategies to recognize mental disorders, and (2) specialized psychosocial services in oncology, which provide psychological support and effective interventions for cancer patients in acute care and rehabilitation.