Boyes Allison W, Girgis Afaf, Zucca Alison C, Lecathelinais Christophe
Centre for Health Research & Psycho-oncology, Cancer Council New South Wales, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia.
Med J Aust. 2009 Apr 6;190(S7):S94-8. doi: 10.5694/j.1326-5377.2009.tb02479.x.
To assess the prevalence and predictors of anxiety and depression among a heterogeneous sample of long-term adult cancer survivors.
Cross-sectional survey of 863 adults diagnosed with a new histologically confirmed cancer (local or metastatic) between 1 April and 30 November 1997 and still alive in 2002, living in NSW, able to read and understand English adequately, physically and mentally capable of participating, and aware of their cancer diagnosis, who were randomly selected from the New South Wales Central Cancer Registry.
Prevalence of anxiety and depression assessed by the Hospital Anxiety and Depression Scale; and factors (patient, disease, and treatment characteristics; coping style; social support) predicting clinical or borderline levels of anxiety and depression.
Levels of anxiety and depression were low; only 9% of participants reported clinically important levels of anxiety and 4% reported depression. The strongest predictive factors of borderline or clinical anxiety were previous treatment for psychological illness, maladaptive coping styles (helplessness-hopelessness, anxious preoccupation) and poor social support. Borderline or clinical depression was most strongly predicted by previous treatment for psychological illness, being an invalid pensioner, maladaptive coping style (helplessness-hopelessness) and poor positive social interaction.
By 5 years after diagnosis, most survivors had adjusted well to their cancer experience, with levels of anxiety and depression similar to those of the general population. Nevertheless, a small and important group of long-term survivors continue to experience adverse psychological effects and need assistance. Monitoring of psychological wellbeing and referring patients when appropriate need to be integrated into routine care for cancer survivors.
评估成年长期癌症幸存者异质性样本中焦虑和抑郁的患病率及预测因素。
对863名成年人进行横断面调查，这些成年人于1997年4月1日至11月30日期间被诊断患有新的经组织学确诊的癌症（局部或转移性），2002年仍存活，居住在新南威尔士州，能够充分阅读和理解英语，身心具备参与能力且知晓自己的癌症诊断，他们是从新南威尔士州中央癌症登记处随机选取的。
采用医院焦虑抑郁量表评估焦虑和抑郁的患病率；以及预测焦虑和抑郁临床或临界水平的因素（患者、疾病和治疗特征；应对方式；社会支持）。
焦虑和抑郁水平较低；只有9%的参与者报告有临床显著水平的焦虑，4%报告有抑郁。临界或临床焦虑的最强预测因素是既往有心理疾病治疗史、适应不良的应对方式（无助 - 绝望、焦虑专注）和社会支持差。临界或临床抑郁的最强预测因素是既往有心理疾病治疗史、为残疾养老金领取者、适应不良的应对方式（无助 - 绝望）和积极社会互动差。
诊断后5年时，大多数幸存者已很好地适应了他们的癌症经历，焦虑和抑郁水平与一般人群相似。然而，一小部分但很重要的长期幸存者仍持续经历不良心理影响且需要帮助。对癌症幸存者的常规护理需要纳入对心理健康的监测并在适当的时候转诊患者。
