Psychiatric disorders and mental health service use among caregivers of advanced cancer patients
Psychiatric disorders and mental health service use among caregivers of advanced cancer patients
复制标题
DOI：
10.1200/jco.2005.01.370
复制
发表时间：
2005-10-01
影响因子：
45.3
通讯作者：
Prigerson, HG
中科院分区：
文献类型：
--
作者：
Vanderwerker, LC;Laff, RE;Prigerson, HG
目的尽管研究表明晚期癌症患者的心理负担，方法对200名晚期癌症患者的非正式照顾者进行访谈，并进行精神疾病诊断和统计手册第四版的结构化临床访谈和心理健康评估。结果13%的照顾者符合精神疾病的标准; 25%的人自患者癌症诊断以来接受了心理健康问题的治疗。当前精神疾病的频率如下：惊恐障碍，8.0%（95% CI，4.6%-12.7%），重度抑郁症，4.5%（95% CI，2.1%至8.4%），创伤后应激障碍，4.0%（95% CI，1.7%至7.7%），广泛性焦虑障碍，3.5%（95% CI，1.4%至7.1%）。在目前患有精神疾病的照顾者中，81%的人在患者癌症诊断前与健康专业人员讨论了心理健康问题，而诊断后为46%（McNemar检验= 5.40; P =.02）。只有46%的目前患有精神疾病的照顾者获得了精神卫生服务。在患者癌症诊断前与临床医生讨论心理健康问题的护理人员（比值比[OR] = 3.51; 95% CI，1.42至8.71）和诊断后（OR = 21.23; 95%氯，9.02至49.94）结论晚期癌症患者的照顾者中，有许多人在接受心理健康服务时，符合标准或正在接受精神问题治疗。讨论心理健康问题对接受心理健康服务有积极影响，应在这一弱势群体中积极开展。
Purpose Despite research demonstrating the psychological burden of caregiving for advanced cancer patients, limited information exists on the prevalence of psychiatric disorders and mental health service use among these informal caregivers.Methods Two hundred informal caregivers of advanced cancer patients were interviewed and administered the Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition and an assessment of mental health service use.Results Thirteen percent of caregivers met criteria for a psychiatric disorder; 25% accessed treatment for mental health concerns since the patient's cancer diagnosis. The frequencies of current psychiatric disorders were as follows: panic disorder, 8.0% (95% Cl, 4.6% to 12.7%), major depressive disorder, 4.5% (95% Cl, 2.1% to 8.4%), post-traumatic stress disorder, 4.0% (95% Cl, 1.7% to 7.7%), and generalized anxiety disorder, 3.5% (95% Cl, 1.4% to 7.1%). Among caregivers with a current psychiatric disorder, 81% discussed mental health concerns with a health professional before the patient's cancer diagnosis compared with 46% after the diagnosis (McNemar test = 5.40; P =.02). Only 46% of caregivers with a current psychiatric disorder accessed mental health services. Caregivers who discussed mental health concerns with a clinician before the patient's cancer diagnosis (odds ratio [OR] = 3.51; 95% Cl, 1.42 to 8.71) and after the diagnosis (OR = 21.23; 95% Cl, 9.02 to 49.94) were more likely than caregivers not having these discussions to receive mental health services.Conclusion Many caregivers of advanced cancer patients either meet criteria or are being treated for psychiatric problems. Discussing mental health issues positively influences the receipt of mental health services and should be actively pursued in this vulnerable population.