Nordin K, Berglund G, Glimelius B, Sjödén P O
Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala Science Park, S-751 83 Uppsala, Sweden.
Eur J Cancer. 2001 Feb;37(3):376-84. doi: 10.1016/s0959-8049(00)00398-1.
The aim of this study was to investigate the possibility of predicting anxiety and depression 6 months after the cancer diagnosis on the basis of measures of anxiety, depression (Hospital Anxiety and Depression, HAD scale), subjective distress (Impact of Event, IES scale) and some aspects of social support in connection with the diagnosis. A further purpose was to attempt identification of individual patients at risk of prolonged psychological distress, and to develop an easily applicable clinical tool for such detection. A consecutive population-based series of 522 newly diagnosed patients with breast, colorectal, gastric and prostate cancer were interviewed in connection with the diagnosis and 6 months later. Anxiety and depression close to the diagnosis explained 39% of the variance in anxiety and depression 6 months later. Patients scoring as doubtful cases/cases for HAD anxiety and/or depression were more than 11 times more likely than non-cases to score as doubtful cases/cases at 6 months. Additional risk factors were having an advanced disease and nobody in addition to the family to rely on in case of difficulties. Levels of anxiety and depression at diagnosis predict a similar status 6 months later. The results also indicate that the HAD scale in combination with a single question about social support may be a suitable screening tool for clinical use.
本研究的目的是基于焦虑、抑郁测量指标（医院焦虑抑郁量表，HAD量表）、主观痛苦感（事件影响量表，IES量表）以及与诊断相关的社会支持的某些方面，探讨在癌症诊断6个月后预测焦虑和抑郁的可能性。另一个目的是尝试识别有长期心理困扰风险的个体患者，并开发一种易于应用的临床检测工具。对连续纳入的522例新诊断的乳腺癌、结直肠癌、胃癌和前列腺癌患者在诊断时及6个月后进行了访谈。诊断时的焦虑和抑郁解释了6个月后焦虑和抑郁差异的39%。在HAD焦虑和/或抑郁量表上被评为可疑病例/病例的患者，在6个月时被评为可疑病例/病例的可能性是非病例患者的11倍多。其他风险因素包括患有晚期疾病以及在遇到困难时除家人外无人可依靠。诊断时的焦虑和抑郁水平可预测6个月后的类似状态。结果还表明，HAD量表结合一个关于社会支持的单一问题可能是一种适合临床使用的筛查工具。
