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妇科肿瘤会诊:症状表现以及抑郁和焦虑的并发症状。

The gynecologic oncology consult: symptom presentation and concurrent symptoms of depression and anxiety.

作者信息

Fowler Jeffrey M, Carpenter Kristen M, Gupta Parul, Golden-Kreutz Deanna M, Andersen Barbara L

机构信息

Department of Obstetrics-Gynecology, Division of Gynecologic Oncology, The Ohio State University, Columbus, OH 43210, USA.

出版信息

Obstet Gynecol. 2004 Jun;103(6):1211-7. doi: 10.1097/01.AOG.0000127983.70739.d8.

Abstract

OBJECTIVE

To detail the relationship of gynecologic symptoms and sociodemographic variables to depression and anxiety reports among women who were referred to gynecologic oncologists for evaluation.

METHODS

Consecutive patients (N = 151) from an National Cancer Institute-designated comprehensive cancer center were accrued and participated on the day of consultation. Patients completed measures assessing depression (Center for Epidemiological Studies Depression Scale) and anxiety (Beck Anxiety Inventory) symptoms, common gynecologic signs/symptoms, and sociodemographic characteristics. Patients were followed up and subsequent diagnoses yielded 73 (48%) cancer and 78 (52%) benign cases.

RESULTS

Descriptive analyses revealed that the cancer group was significantly older (52 versus 45 years) than the benign group, and variables correlated with age also differed significantly, with the cancer sample more likely to be postmenopausal, unemployed, and if employed, working fewer hours per week. Importantly, the groups did not differ on reports of depressive, anxiety, or gynecologic symptoms. Hierarchical multiple regression analyses, collapsing across groups, yielded significant correlates of emotional distress. Women who were older, without a spouse/partner, and who had more gynecologic symptoms had higher levels of both depressive and anxiety symptoms. Among the women who did have a partner, those with relationships of longer duration reported lower levels of depression/anxiety

CONCLUSION

Reports of clinically significant depressive (42%) and anxiety symptoms (30%) were high. The number of gynecologic symptoms was reliably correlated with emotional distress. Age and absence of partner may have conferred added vulnerability. For those women with partners, lengthier relationships appeared to offer protection from both depressive and anxiety symptoms.

LEVEL OF EVIDENCE

III

摘要

目的

详细阐述在被转介至妇科肿瘤学家处进行评估的女性中,妇科症状及社会人口统计学变量与抑郁和焦虑报告之间的关系。

方法

从一家美国国立癌症研究所指定的综合癌症中心连续招募患者(N = 151),并在会诊当天参与研究。患者完成了评估抑郁(流行病学研究中心抑郁量表)和焦虑(贝克焦虑量表)症状、常见妇科体征/症状以及社会人口统计学特征的测量。对患者进行随访,后续诊断产生了73例(48%)癌症病例和78例(52%)良性病例。

结果

描述性分析显示,癌症组比良性组年龄显著更大(52岁对45岁),且与年龄相关的变量也存在显著差异,癌症样本更可能处于绝经后、失业状态,并且如果有工作,每周工作时长更少。重要的是,两组在抑郁、焦虑或妇科症状报告方面并无差异。跨组进行的分层多元回归分析得出了情绪困扰的显著相关因素。年龄较大、没有配偶/伴侣且有更多妇科症状的女性,抑郁和焦虑症状水平更高。在有伴侣的女性中,关系持续时间较长的女性报告的抑郁/焦虑水平较低。

结论

具有临床意义的抑郁症状(42%)和焦虑症状(30%)的报告率较高。妇科症状的数量与情绪困扰可靠相关。年龄和没有伴侣可能增加了易感性。对于那些有伴侣的女性,较长的关系似乎能预防抑郁和焦虑症状。

证据水平

III

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