Grulke Norbert, Larbig Wolfgang, Kächele Horst, Bailer Harald
University Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany.
Psychooncology. 2008 May;17(5):480-7. doi: 10.1002/pon.1261.
Depression is discussed as a possible risk factor for survival in cancer patients. We explored this relationship for patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT).
The depression subscale of the Hospital Anxiety and Depression Scale (HADS) served as a measure for depression. One hundred and thirty-eight patients (mean age 41 years; different diagnoses) participating in a psycho-oncology study filled in the HADS after admission for allogeneic HSCT. They were followed-up for at least two years; 72 patients died during follow-up.
Depression scores were not correlated with medical and psychosocial objective factors with the exception of having under-aged children. Controlling for medical factors that showed up as predictors for survival in our sample (patient's age at HSCT, having had a transplant before, risk for treatment failure) the HADS depression score (range 0-21) emerged as an independent predictor (Cox regression): hazard ratio = 1.087, 95% CI = 1.018-1.161.
Depression is probably not a simple indicator of a worse health status. Further research is needed to decide if depression must be considered as an independent risk factor for survival when diagnosed in the pre-transplant period.
抑郁症被认为是癌症患者生存的一个潜在风险因素。我们探讨了接受异基因造血干细胞移植（HSCT）患者的这种关系。
医院焦虑抑郁量表（HADS）中的抑郁分量表用作抑郁症的衡量指标。138名参与心理肿瘤学研究的患者（平均年龄41岁；诊断各异）在接受异基因HSCT入院后填写了HADS量表。对他们进行了至少两年的随访；72名患者在随访期间死亡。
除了有未成年子女外，抑郁评分与医学及心理社会客观因素均无相关性。在控制了我们样本中显示为生存预测因素的医学因素（HSCT时患者年龄、既往是否接受过移植、治疗失败风险）后，HADS抑郁评分（范围0 - 21）成为一个独立预测因素（Cox回归）：风险比 = 1.087，95%置信区间 = 1.018 - 1.161。
抑郁可能并非健康状况较差的简单指标。需要进一步研究以确定在移植前期诊断出的抑郁症是否必须被视为生存的独立风险因素。
