van der Lee Marije L, van der Bom Johanna G, Swarte Nikkie B, Heintz A Peter M, de Graeff Alexander, van den Bout Jan
Department of Clinical Psychology, Faculty Social Sciences, Utrecht University, Utrecht, the Netherlands.
J Clin Oncol. 2005 Sep 20;23(27):6607-12. doi: 10.1200/JCO.2005.14.308. Epub 2005 Aug 22.
To study the association between depression and the incidence of explicit requests for euthanasia in terminally ill cancer patients.
A prospective cohort study was conducted on 138 consecutive cancer patients with an estimated life expectancy of 3 months or less, in the period between September 1999 and August 2003. At inclusion, participants completed the Hospital Anxiety and Depression Scale. To identify "depressed mood" we used a cutoff score of 20. Kaplan-Meier curves and Cox regression analyses were used to assess the association between depressed mood and the risk of a request for euthanasia.
Of 138 patients, 32 patients had depressed mood at inclusion. Thirty patients (22%) made an explicit request for euthanasia. The risk to request euthanasia for patients with depressed mood was 4.1 times higher than that of patients without depressed mood at inclusion (95% CI, 2.0 to 8.5).
Depression in cancer patients with an estimated life expectancy of less than 3 months is associated with a higher likelihood to request for euthanasia. The question of whether depressed mood can adequately be treated in this terminally ill population, and if so, whether it would lower the incidence of requests for euthanasia needs further investigation.
研究晚期癌症患者的抑郁与明确提出安乐死请求的发生率之间的关联。
在1999年9月至2003年8月期间，对138例连续的预期寿命在3个月或更短的癌症患者进行了一项前瞻性队列研究。纳入时，参与者完成了医院焦虑抑郁量表。为确定“抑郁情绪”，我们使用了20分的临界值。采用Kaplan-Meier曲线和Cox回归分析来评估抑郁情绪与安乐死请求风险之间的关联。
138例患者中，32例在纳入时有抑郁情绪。30例（22%）明确提出了安乐死请求。纳入时伴有抑郁情绪的患者请求安乐死的风险比无抑郁情绪的患者高4.1倍（95%可信区间，2.0至8.5）。
预期寿命小于3个月的癌症患者的抑郁与提出安乐死请求的可能性较高有关。在这个晚期患者群体中，抑郁情绪是否能够得到充分治疗，以及如果可以，这是否会降低安乐死请求的发生率，这些问题需要进一步研究。
