Hopko Derek R, Bell John L, Armento Maria E A, Robertson Sarah M C, Hunt Melissa K, Wolf Nicole J, Mullane Christine
University of Tennessee-Knoxville, Knoxville, TN, 37996, USA.
J Psychosoc Oncol. 2008;26(1):31-51. doi: 10.1300/j077v26n01_03.
Clinical depression is the most common psychiatric disorder among cancer patients and is associated with significant functional impairment. Unfortunately, depression in cancer patients is often under- diagnosed and untreated, and studies examining the predictive utility of assessment instruments in detecting clinically depressed cancer patients are sparse. Using a structured interview, thirty-three patients with various cancer types were diagnosed as having major depression (n = 24) or no psychiatric diagnosis (n = 9). All patients were administered the Beck Depression Inventory-II (BDI-II), the Center for Epidemiological Studies in Depression Scale (CES-D), Hamilton Rating Scale for Depression (HRSD), Quality of Life Inventory (QOLI), a medical and psychosocial functioning questionnaire (SF-36), and given co-morbidity of depression with anxiety disorders, the Beck Anxiety Inventory (BAI). Depressed and non-depressed cancer patients were compared and contrasted across all assessment measures and accuracy of instruments was based on evaluating their sensitivity, specificity, and positive predictive values. Depressed cancer patients exhibited more severe depressive symptoms and poorer quality of life, increased anxiety and bodily pain, and decreased vitality and social functioning. All instruments exhibited strong predictive properties, with the CES-D and BDI-II considered most feasible given their time efficiency, administrative simplicity, and strong psychometric properties.
临床抑郁症是癌症患者中最常见的精神障碍，与显著的功能损害相关。不幸的是，癌症患者的抑郁症常常未被充分诊断和治疗，而且研究评估工具在检测临床抑郁症癌症患者方面的预测效用的研究很少。通过结构化访谈，33名患有各种癌症类型的患者被诊断为患有重度抑郁症（n = 24）或无精神疾病诊断（n = 9）。所有患者均接受了贝克抑郁量表第二版（BDI-II）、流行病学研究中心抑郁量表（CES-D）、汉密尔顿抑郁评定量表（HRSD）、生活质量量表（QOLI）、一份医疗和心理社会功能问卷（SF-36），并鉴于抑郁症与焦虑症的共病情况，还接受了贝克焦虑量表（BAI）。对抑郁和非抑郁的癌症患者在所有评估指标上进行了比较和对比，工具的准确性基于评估其敏感性、特异性和阳性预测值。抑郁的癌症患者表现出更严重的抑郁症状、更差的生活质量、增加的焦虑和身体疼痛，以及活力和社会功能下降。所有工具都表现出很强的预测特性，鉴于其时间效率、管理简便性和强大的心理测量特性，CES-D和BDI-II被认为是最可行的。
