Atesci Figen Culha, Baltalarli Bahar, Oguzhanoglu Nalan Kalkan, Karadag Filiz, Ozdel Osman, Karagoz Nursel
Psychiatry Department, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
Support Care Cancer. 2004 Mar;12(3):161-7. doi: 10.1007/s00520-003-0585-y. Epub 2004 Jan 28.
A significant proportion of cancer patients experience psychiatric morbidity. Potential predictors of psychiatric morbidity include patient disease-related factors and factors relating to the patient's environment. The aim of this study was to investigate the prevalence of psychiatric morbidity and the relationship between the clinical or personal factors, especially psychiatric morbidity, and awareness of cancer diagnosis among a group of Turkish cancer patients. A total of 117 cancer patients were assessed using the Structured Clinical Interview for DSM-IV (SCID), the Hospital and Anxiety Depression Scale (HADS) and the General Health Questionnaire (GHQ). Of these patients, 30% had a psychiatric diagnosis. Adjustment disorders comprised most of the psychiatric diagnoses. Awareness of the diagnosis of cancer, history of previous psychiatric disorders, pain and stress factors were correlated with psychiatric morbidity. Of the 117 patients, 64 (54.7%) were unaware of the diagnosis of cancer. Most of the patients (67.9%) who were considered to be aware of the cancer diagnosis stated that they had guessed their illness from the treatment process or drug adverse effects. Psychiatric morbidity was significantly higher in the patients who knew that they had a cancer diagnosis (P=0.03). These findings suggest that the awareness of cancer diagnosis is related to the presence of psychiatric morbidity. In particular, the understanding of the diagnosis indirectly may be stressful to the patient because it arouses suspicion about the cancer and treatment, and consequently can lead to psychiatric disturbance. In Turkey honest disclosure of the true diagnosis is still not common for cancer patients and it seems to be essential to improve this situation.
相当一部分癌症患者存在精神疾病。精神疾病的潜在预测因素包括与患者疾病相关的因素以及与患者环境相关的因素。本研究的目的是调查一组土耳其癌症患者中精神疾病的患病率，以及临床或个人因素，尤其是精神疾病与癌症诊断知晓情况之间的关系。使用《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈、医院焦虑抑郁量表（HADS）和一般健康问卷（GHQ）对总共117名癌症患者进行了评估。在这些患者中，30%有精神疾病诊断。适应障碍占大多数精神疾病诊断。癌症诊断知晓情况、既往精神疾病史、疼痛和压力因素与精神疾病相关。在117名患者中，64名（54.7%）不知道自己患有癌症。大多数被认为知晓癌症诊断的患者（67.9%）表示他们是从治疗过程或药物不良反应中猜出自己的病情的。知道自己患有癌症诊断的患者精神疾病患病率显著更高（P = 0.03）。这些发现表明癌症诊断知晓情况与精神疾病的存在有关。特别是，间接了解诊断可能会给患者带来压力，因为这会引发对癌症和治疗的怀疑，从而可能导致精神障碍。在土耳其，向癌症患者如实披露真实诊断仍然不常见，改善这种情况似乎至关重要。
