Desaive Patrick, Ronson Alain
Institut Jules Bordet, Université Libre de Bruxelles, Psycho-Oncology Unit, Belgium.
Curr Opin Oncol. 2008 Jul;20(4):378-85. doi: 10.1097/CCO.0b013e328302166a.
In this study, we will review the clinical, biological and research challenges resulting from the application of the traumatic stress framework to the psychological experience of cancer. Theoretical controversy over that conceptual shift and tentative neurobiological correlations are discussed. We will attempt to extract significant advances from the general literature and describe new directions for therapeutic strategies.
The traumatic nature of cancer experience is supported by epidemiology, but criticized by many authors, highlighting methodological caveats and conceptual contradictions. However, neuroimaging studies provide common findings in cancer patients with posttraumatic stress disorder, as it has been described in posttraumatic stress disorder patients. The carcinogenic effects of catecholamines and glucocorticoids could open the way for a deeper understanding of correlations between psychological factors and cancer prognosis.
Cancer is a unique psychological experience. Its relapsing course and life-threatening nature constitute a potential source of severe and chronic stress, resulting in long-term psychological distress, poor quality of life and psychopathology. Biological consequences of cumulative stress include catecholamine hyperactivity and glucocorticoid dysregulation, and also affect the immune system. The understanding of those physiopathologic pathways needs further investigation, as the development of adequate screening tools does. In order to integrate all those challenges, multidisciplinary approaches are warranted.
在本研究中,我们将回顾因将创伤应激框架应用于癌症患者心理体验而产生的临床、生物学及研究方面的挑战。讨论了围绕该概念转变的理论争议以及初步的神经生物学关联。我们将尝试从一般文献中提炼出重大进展,并描述治疗策略的新方向。
癌症经历的创伤性质得到了流行病学的支持,但遭到了许多作者的批评,他们强调了方法学上的注意事项和概念上的矛盾之处。然而,神经影像学研究在患有创伤后应激障碍的癌症患者中发现了与创伤后应激障碍患者中所描述的相同的常见结果。儿茶酚胺和糖皮质激素的致癌作用可能为更深入理解心理因素与癌症预后之间的关联开辟道路。
癌症是一种独特的心理体验。其复发过程和危及生命的性质构成了严重且慢性应激的潜在来源,导致长期心理困扰、生活质量低下和精神病理学问题。累积应激的生物学后果包括儿茶酚胺活性过高和糖皮质激素失调,并且还会影响免疫系统。对这些病理生理途径的理解以及合适筛查工具的开发都需要进一步研究。为了应对所有这些挑战,多学科方法是必要的。