Depression and anxiety disorders in palliative cancer care
Depression and anxiety disorders in palliative cancer care
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DOI：
10.1016/j.jpainsymman.2006.07.016
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发表时间：
2007-02-01
影响因子：
4.7
通讯作者：
Clinch, Jennifer J.
中科院分区：
文献类型：
--
作者：
Wilson, Keith G.;Chochinov, Harvey Max;Clinch, Jennifer J.
抑郁症和焦虑症被认为是癌症姑息治疗中常见的，但关于它们与生活质量其他方面的相关性，证据不一致。在加拿大国家姑息治疗调查中，对381名接受姑息治疗的癌症患者进行了评估抑郁症和焦虑症的半结构化访谈。有212名女性和169名男性，中位生存期为63天。我们发现，93名参与者（24.4%，95%置信区间= 20.2-29.0）符合精神障碍诊断和统计手册第四版至少一种焦虑或抑郁障碍的诊断标准（抑郁障碍患病率为20.7%，焦虑障碍患病率为13.9%）。最常见的个体诊断是重度抑郁症（13.1%，95%置信区间= 9.9-16.9）。合并症很常见，10.2%的参与者符合一种以上疾病的标准。被诊断患有疾病的人明显比其他参与者年轻（P = 0.002）。他们也有较低的性能状态（P = 0.017），较小的社交网络（P = 0.008），并较少参与有组织的宗教服务（P = 0.007）。此外，他们报告了18种身体症状中的14种，社会问题和存在问题的更严重的痛苦。在那些患有疾病的人中，39.8%正在接受抗抑郁药物治疗，66.7%的人被开了苯二氮卓类药物。总之，看来，在接受姑息治疗的患者中，抑郁症和焦虑症确实很常见。这些疾病导致死于癌症的人的生活质量大大降低。
Depression and anxiety disorders are thought to be common in palliative cancer care, but there is inconsistent evidence regarding their relevance for other aspects of quality of life. In the Canadian National Palliative Care Survey, semi-structured interviews assessing depression and anxiety disorders were administered to 381 patients who were receiving palliative care for cancer. There were 212 women and 169 men, with a median survival of, 63 days. We found that 93 participants (24.4 %, 95 % confidence interval= 20.2-29.0) fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for at least one anxiety or depressive disorder (20.7% prevalence of depressive disorders, 13.9% prevalence of anxiety disorders). The most frequent individual diagnosis was major depression (13.1%, 95% confidence interval = 9.9-16.9). Comorbidity was common, with 10.2% of participants meeting criteria for more than one disorder. Those diagnosed with a disorder were significantly younger than other participants (P = 0.002). They also had lower performance status (P = 0.017), smaller social networks (P = 0.008), and less participation in organized religious services (P = 0.007). In addition, they reported more severe distress on 14 of 18 physical symptoms, social concerns, and existential issues. Of those with a disorder, 39.8% were being treated, with antidepressant medication, and 66.7% bad been prescribed a benzodiazepine. In conclusion, it appears that, de/nession, and anxiety disorders are indeed common among patients receiving palliative care. The disorders contribute to a greatly diminished quality of life among people who are dying of cancer.