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喉癌患者精神障碍的筛查:六种方法的比较

Screening for mental disorders in laryngeal cancer patients: a comparison of 6 methods.

作者信息

Singer Susanne, Danker Helge, Dietz Andreas, Hornemann Beate, Koscielny Sven, Oeken Jens, Matthäus Christoph, Vogel Hans-Joachim, Krauss Oliver

机构信息

Department of Social Medicine, University of Leipzig, Germany.

出版信息

Psychooncology. 2008 Mar;17(3):280-6. doi: 10.1002/pon.1229.

Abstract

OBJECTIVES

The aim of this study was to determine how accurate mental distress screening instruments are in identifying psychological sequelae in ambulatory laryngeal cancer patients who have undergone surgery.

METHODS

Two-hundred and fifty subjects were tested for mental disorders according to the guidelines defined in the Diagnostic Statistical Manual of Psychological Illnesses, Version 4. Screening instruments tested were: the 'Hospital Anxiety and Depression Scale' (HADS), the subscale 'Emotional Functioning' of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), the 'Hornheider Fragebogen' (HFB), and a single-item visual analogues scale (VAS). Accuracy was assessed by calculating the sensitivity rates, specificity rates, and areas under the curve from the receiver operating characteristic curves.

RESULTS

The relative frequency of mental disorders was 19.8%. All of the screening instruments tested were found to be highly accurate. The best levels of sensitivity and specificity were associated with the total score of the HADS.

CONCLUSIONS

These results confirm that a significant minority of laryngeal cancer patients suffer from severe mental distress, and that accurate screening for clinically significant mental disorders is possible using any of the instruments evaluated here.

摘要

目的

本研究旨在确定心理困扰筛查工具在识别接受手术的门诊喉癌患者心理后遗症方面的准确性。

方法

根据《精神疾病诊断与统计手册》第4版定义的指南,对250名受试者进行精神障碍测试。所测试的筛查工具包括:“医院焦虑抑郁量表”(HADS)、欧洲癌症研究与治疗组织生活质量核心问卷(EORTC QLQ-C30)的“情绪功能”子量表、“霍恩海德问卷”(HFB)以及单项视觉模拟量表(VAS)。通过计算受试者工作特征曲线的敏感度、特异度和曲线下面积来评估准确性。

结果

精神障碍的相对发生率为19.8%。所有测试的筛查工具都被发现具有高度准确性。最佳的敏感度和特异度水平与HADS总分相关。

结论

这些结果证实,相当一部分喉癌患者存在严重的心理困扰,并且使用此处评估的任何一种工具都有可能对具有临床意义的精神障碍进行准确筛查。

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