Massie Mary Jane
Department of Psychiatry and Behavioral Science, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
J Natl Cancer Inst Monogr. 2004(32):57-71. doi: 10.1093/jncimonographs/lgh014.
Depression is the psychiatric syndrome that has received the most attention in individuals with cancer. The study of depression has been a challenge because symptoms occur on a broad spectrum that ranges from sadness to major affective disorder and because mood change is often difficult to evaluate when a patient is confronted by repeated threats to life, is receiving cancer treatments, is fatigued, or is experiencing pain. Although many research groups have assessed depression in cancer patients since the 1960s, the reported prevalence (major depression, 0%-38%; depression spectrum syndromes, 0%-58%) varies significantly because of varying conceptualizations of depression, different criteria used to define depression, differences in methodological approaches to the measurement of depression, and different populations studied. Depression is highly associated with oropharyngeal (22%-57%), pancreatic (33%-50%), breast (1.5%-46%), and lung (11%-44%) cancers. A less high prevalence of depression is reported in patients with other cancers, such as colon (13%-25%), gynecological (12%-23%), and lymphoma (8%-19%). This report reviews the prevalence of depression in cancer patients throughout the course of cancer.
抑郁症是癌症患者中最受关注的精神综合征。抑郁症的研究颇具挑战性,因为其症状范围广泛,从悲伤到重度情感障碍不等,而且当患者面临反复的生命威胁、接受癌症治疗、感到疲劳或经历疼痛时,情绪变化往往难以评估。自20世纪60年代以来,尽管许多研究小组对癌症患者的抑郁症进行了评估,但由于对抑郁症的概念化不同、定义抑郁症所使用的标准不同、测量抑郁症的方法学途径不同以及所研究的人群不同,报告的患病率(重度抑郁症为0%-38%;抑郁症谱系综合征为0%-58%)差异很大。抑郁症与口咽癌(22%-57%)、胰腺癌(33%-50%)、乳腺癌(1.5%-46%)和肺癌(11%-44%)高度相关。据报道,其他癌症患者如结肠癌(13%-25%)、妇科癌症(12%-23%)和淋巴瘤(8%-19%)的抑郁症患病率较低。本报告回顾了癌症患者在整个癌症病程中抑郁症的患病率。