Dolbeault Sylvie, Bredart Anne, Mignot Véronique, Hardy Patrick, Gauvain-Piquard Annie, Mandereau Laurence, Asselain Bernard, Medioni Jacques
Unité de Psycho-Oncologic, Départment Interdiscioplinaire de Soins de Support pour le Patient en Oncologie, Paris, France.
Palliat Support Care. 2008 Jun;6(2):107-17. doi: 10.1017/S1478951508000187.
Little is known about the prevalence of psychiatric disorders in French cancer patients. This study aimed to assess the feasibility of a screening procedure using the Psychological Distress Scale (PDS). The PDS is a French adaptation of the National Comprehensive Cancer Network Distress Thermometer. The screening performance of the PDS was assessed by comparison with the established clinical case threshold on the Hospital Anxiety and Depression Scale (HADS).
Among 598 consecutive cancer outpatients recruited in two cancer centers in Paris, 561 (94%) agreed to complete the PDS, the HADS, the European Organisation for Research and Treatment of Cancer core quality of life questionnaire (EORTC QLQ-C30), and study-specific psychosocial questions.
A receiver operating characteristic (ROC) analysis was performed, using a HADS cutoff score of 15 or greater to identify patients with psychological distress. This yielded a PDS cutoff score of 3, giving 76% sensitivity and 82% specificity. With this cutoff score, the prevalence of psychological distress was 38%. PDS scores were significantly related to scores from the HAD total scale (r=.64), HAD anxiety (r=.61) and HAD depression (r=.39) subscales, and EORTC QLQ-C30 emotional functioning (r=.56) and global health state (r=.44). In multivariate analyses, factors associated with psychological distress were female gender, taking analgesics, receiving professional psychological help, perceived psychosocial difficulties and lack of social support.
Using the PDS appeared feasible, acceptable and effective for psychological distress screening in French ambulatory cancer care settings.
对于法国癌症患者精神障碍的患病率了解甚少。本研究旨在评估使用心理困扰量表（PDS）进行筛查程序的可行性。PDS是美国国立综合癌症网络苦恼温度计的法语改编版。通过与医院焦虑抑郁量表（HADS）既定的临床病例阈值进行比较，评估PDS的筛查性能。
在巴黎两个癌症中心招募的598名连续癌症门诊患者中，561名（94%）同意完成PDS、HADS、欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）以及特定研究的社会心理问题。
进行了受试者工作特征（ROC）分析，使用HADS临界值分数15分及以上来识别有心理困扰的患者。这得出PDS临界值分数为3分，灵敏度为76%，特异度为82%。以此临界值分数，心理困扰的患病率为38%。PDS分数与HAD总量表（r = 0.64）、HAD焦虑（r = 0.61）和HAD抑郁（r = 0.39）子量表的分数，以及EORTC QLQ-C30情绪功能（r = 0.56）和总体健康状况（r = 0.44）显著相关。在多变量分析中，与心理困扰相关的因素为女性、服用镇痛药、接受专业心理帮助、感知到的社会心理困难以及缺乏社会支持。
在法国门诊癌症护理环境中，使用PDS进行心理困扰筛查似乎是可行的、可接受的且有效的。
