Hegel Mark T, Moore Caroline P, Collins E Dale, Kearing Stephen, Gillock Karen L, Riggs Raine L, Clay Kate F, Ahles Tim A
Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire, USA.
Cancer. 2006 Dec 15;107(12):2924-31. doi: 10.1002/cncr.22335.
Emotional distress and psychiatric syndromes are prevalent in the breast cancer population at large. However, to date there is a paucity of literature specifically concerning presurgical breast cancer patients.
The authors assessed 236 newly diagnosed patients at the time of their presurgical consultation at the Comprehensive Breast Cancer Program of Dartmouth-Hitchcock Medical Center in Lebanon, NH.
Of patients in this study, 41% rated their distress in the clinically significant range on the Distress Thermometer (ie, >5, 0-10 scale). Nearly one-half (47%) of patients met established thresholds for positivity on 1 or more screens for distress or psychiatric disorders. Prevalence rates were 11% for major depression (60% of these patients were moderately severe to severely depressed) and were 10% for posttraumatic stress disorder (PTSD). Emotional symptoms markedly interfered with daily function in both groups. Of depressed patients, 56% were already taking a psychotropic medication, yet they still met screening criteria for major depression.
Emotional distress and psychiatric syndromes (major depression and PTSD) were prevalent in this population. Markedly impaired function was evident for both depressed and PTSD patients. Future research should refine current screening procedures and develop interventions to better address emotional distress and psychiatric disorders in newly diagnosed breast cancer patients.
情绪困扰和精神综合征在乳腺癌患者群体中普遍存在。然而,迄今为止,专门针对乳腺癌术前患者的文献较少。
作者对新罕布什尔州黎巴嫩市达特茅斯-希区柯克医疗中心综合乳腺癌项目中236名新诊断患者在术前咨询时进行了评估。
在本研究患者中,41%的患者在痛苦温度计上的痛苦程度处于临床显著范围(即0至10分的量表上>5分)。近一半(47%)的患者在1次或多次痛苦或精神障碍筛查中达到了既定的阳性阈值。重度抑郁症的患病率为11%(这些患者中有60%为中度至重度抑郁),创伤后应激障碍(PTSD)的患病率为10%。情绪症状在两组中均显著干扰日常功能。在抑郁患者中,56%已经在服用精神药物,但他们仍符合重度抑郁症的筛查标准。
情绪困扰和精神综合征(重度抑郁症和创伤后应激障碍)在该群体中普遍存在。抑郁和创伤后应激障碍患者的功能均明显受损。未来的研究应完善当前的筛查程序,并开发干预措施,以更好地应对新诊断乳腺癌患者的情绪困扰和精神障碍。