Identifying and Measuring Depression in Older Cancer Patients

描述（由申请人提供）：国际移民组织的报告指出，到2030年，20%的人口将超过65岁。目前，60%的癌症诊断和70%的癌症死亡发生在这个年龄组。在这个国家，几乎三分之二的癌症幸存者是老年人，这些百分比在未来20到30年内将继续上升。抑郁症被认为是老年人最关心的五个问题之一，老年癌症患者中抑郁症的患病率为17 - 25%。抑郁症，从孤立的抑郁症状到重度抑郁症，与生活质量下降，体力活动恶化，关系困难，照顾负担和更大的疼痛有关。据估计，美国抑郁症的经济负担每年超过520亿美元。然而，尽管抑郁症的患病率和有害影响很高，但老年癌症患者被诊断患有抑郁症（严重或轻微）的可能性远远低于任何其他年龄组。老年癌症患者抑郁症诊断不足的一个原因是这些患者可能没有报告经典的DSM-IV标准。抑郁症的自我报告测量通常是识别抑郁症状并进行适当心理健康转介的有效且具有成本效益的方法。然而，缺乏心理测量数据建立现有的抑郁症测量工具在老年癌症患者的有效性，因为这些工具通常是基于DSM标准或抑郁症的经典症状，这是不太可能的，他们可以有效地评估抑郁症状在这一人群中。这项提案代表了一项研究计划的第一步，该计划旨在识别，量化并最终缓解老年癌症患者的抑郁症，并将探索老年癌症患者如何体验和表达抑郁症，并开发一个针对这一庞大但未被充分认识的人群的自我报告量表。该建议的目的是：1）确定老年癌症患者的抑郁现象，2）开发一套指标，以确定老年癌症患者的抑郁症，并以问卷项目的形式操作这些指标，和3）评估的初步心理测量学特性的抑郁症的自我报告措施，适合老年癌症患者的需要。 公共卫生相关性：国际移民组织的报告指出，到2030年，20%的人口将超过65岁。目前，60%的癌症诊断和70%的癌症死亡发生在这个年龄段。美国近三分之二的癌症幸存者是老年人，在未来20至30年内，这一比例将继续上升。抑郁症被认为是老年人最关心的五个问题之一，老年癌症患者中抑郁症的患病率为17 - 25%。然而，尽管抑郁症的高患病率和有害影响，老年癌症患者被诊断为抑郁症（严重或轻微）或心境恶劣的可能性远远低于任何其他年龄组。本研究将探讨老年癌症患者抑郁的概念框架，并开始编制一份简短的问卷，以识别这组患者的抑郁。

DESCRIPTION (provided by applicant): The IOM Report states that by 2030, 20% of the population will be over 65. Currently, 60% of cancer diagnoses and 70% of deaths from cancer occur in this age group. Almost two-thirds of cancer survivors in this country are elderly and these percentages will continue to rise for the next 20 to 30 years. Depression is considered one of the top five concerns for the elderly and the prevalence of depressive disorders in older cancer patients ranges from 17-25%. Depression, throughout the spectrum from isolated depressive symptoms to major depressive disorder, is associated with decreased quality of life, deterioration in physical activities, relationship difficulties, caretaker burden, and greater pain. The economic burden of depression in the US has been estimated to be greater than 52 billion dollars a year. Yet, despite the high prevalence rates and deleterious effects of depression, elderly cancer patients are far less likely to be diagnosed with depression (major or minor) than any other age group. One reason for the underdiagnosis of depression in older cancer patients is that these patients may not report classic DSM-IV criteria. Self-report measures of depression are often an efficient and cost-effective way to identify depressive symptoms and make appropriate mental health referrals. However, there is a dearth of psychometric data establishing the validity of existing depression measurement tools in older cancer patients, and because these instruments are typically based on DSM criteria or classic symptoms of depression, it is unlikely that they can effectively assess depressive symptoms in this population. This proposal represents the first step in a program of research geared towards identifying, quantifying, and ultimately alleviating depression in older cancer patients, and will explore how older adults with cancer experience and express depressive symptomatology and develop a self-report scale tailored to this large, but under-recognized, population. The aims of this proposal are: 1) To identify the phenomenology of depression in older cancer patients, 2) To develop a set of indicators to identify depression in older cancer patients and operationalize these indicators in the form of questionnaire items, and 3) To evaluate the preliminary psychometric properties of a self-report measure of depression tailored to the needs of older cancer patients. PUBLIC HEALTH RELEVANCE: The IOM Report points out that by 2030, 20% of the population will be over 65. Currently, 60% of cancer diagnoses and 70% of deaths from cancer occur in this age group. Almost two-thirds of cancer survivors in this country are elderly and these percentages will continue to rise over the next 20 to 30 years. Depression is considered one of the top five concerns for the elderly and the prevalence of depressive disorders in older cancer patients ranges from 17-25%. Yet, despite the high prevalence rates and deleterious effects of depression, elderly cancer patients are far less likely to be diagnosed with depression (major or minor) or dysthymia than any other age group. This study will explore the conceptual framework of depression in older cancer patients, and begin to develop a brief questionnaire to identify depression in this group of patients.