Mixed Anxiety/Depression Symptoms in a Large Cancer Cohort: Prevalence by Cancer Type
Mixed Anxiety/Depression Symptoms in a Large Cancer Cohort: Prevalence by Cancer Type
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DOI：
10.1176/appi.psy.50.4.383
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发表时间：
2009-07-01
期刊：
影响因子：
3.4
通讯作者：
Zabora, James R.
中科院分区：
文献类型：
--
作者：
Brintzenhofe-Szoc, Karlynn M.;Levin, Tomer T.;Zabora, James R.
背景：混合性焦虑/抑郁与较差的社会心理和治疗结果、较差的生活质量、较差的治疗依从性、较慢的恢复、较高的自杀风险和较高的成本利用相关。目的：本研究旨在探讨这些症状的癌症特异性患病率。方法：采用简要症状量表收集某三级癌症中心门诊成人患者的焦虑和抑郁症状的横截面数据（N = 8265）。结果：12.4%的患者出现焦虑/抑郁混合症状；整体抑郁症状占18.3%，整体焦虑症状占24.0%，单纯焦虑症状占11.7%，单纯抑郁症状占6.0%；70%的人两者都没有。胃癌、胰腺癌、头颈癌和肺癌患者出现焦虑/抑郁混合症状的比例较高，但乳腺癌患者出现焦虑/抑郁混合症状的比例较低。三分之二的抑郁症癌症患者出现焦虑/抑郁混合表型。讨论：70%的患者没有达到抑郁或焦虑症状的阈值，这一事实可以解释为对这些症状发展到显著水平的抵抗的反映。然而，由于胃癌、胰腺癌、头颈癌和肺癌具有更高水平的混合焦虑/抑郁症状，因此可以提出一个问题，即这些症状是否与更生物学类型的焦虑/抑郁（例如，由于细胞因子释放）有关，以及这种表型是否应该积极靶向，因为它在这些癌症中经常发生。（Psychosomatics 2009; 50: 383-391）
Background: Mixed anxiety/depression is associated with poorer psychosocial and treatment outcomes, worse quality of life, poorer adherence to treatment, slower recovery, greater suicide risk, and higher cost-utilization. Objective: This study aimed to examine the cancer-specific prevalence of these symptoms. Method: Cross-sectional anxiety and depression symptom data were collected with the Brief Symptom Inventory from adult outpatients presenting to a tertiary cancer center (N = 8,265). Results: Mixed anxiety/depression symptoms were seen in 12.4% of patients; overall depression symptoms in 18.3%, overall anxiety symptoms in 24.0%, pure anxiety symptoms in 11.7%, and pure depression symptoms in 6.0%; 70% had neither. Higher rates of mixed anxiety/depression symptoms were seen with stomach, pancreatic, head and neck, and lung cancers, but lower rates were seen in those with breast cancers. The mixed anxiety/depression phenotype occurs in two-thirds of depressed cancer patients. Discussion: The fact that 70% of patients did not meet thresholds for depression or anxiety symptoms can be interpreted as a reflection of the resistance to developing a significant level of these symptoms. However, because stomach, pancreatic, head and neck, and lung cancers have higher levels of mixed anxiety/depression symptoms, the question can be raised as to whether these are associated with a more biological type of anxiety/depression (e.g., due to cytokine release) and whether this phenotype should be actively targeted because of its frequent occurrence in these cancers. (Psychosomatics 2009; 50: 383-391)