Department of Behavior and Communication, Section of Psychiatry, University of Ferrara, Ferrara, Italy.
Psychother Psychosom. 2010;79(1):39-47. doi: 10.1159/000259416. Epub 2009 Nov 18.
So far, no study has tested supportive-expressive group therapy (SEGT) in cancer patients with an established psychiatric diagnosis. The aim of this 6-month follow-up study was to evaluate breast cancer patients with an ICD-10 diagnosis of affective syndromes participating in SEGT and a group of breast cancer patients with no ICD-10 diagnosis.
A total of 214 patients were examined in the screening phase (T0) using the ICD-10, the Brief Symptom Inventory (BSI), the Mini-Mental Adjustment-to-Cancer Scale (Mini-MAC), the Multidimensional Scale of Perceived Social Support, the Openness Scale and the Cancer Worries Inventory (CWI). Those with an ICD-10 diagnosis of affective syndromes received 16-24 sessions of SEGT (90-min sessions, once a week), while those with no ICD-10 diagnosis were followed up. A second assessment for both sam- ples took place 6 months later (T1).
Seventy-eight (36.4%) patients were positive for an ICD-10 diagnosis of affective syndromes at T0, while 127 (59.4%) did not meet any ICD-10 diagnosis. Among the former, 54 patients participated in the SEGT. At T1, significant differences were observed in all the dimensions of the BSI, hopelessness and anxious preoccupation subscales of the Mini-MAC, the Openness Scale and the CWI. No variable at T0 was a predictor of BSI distress as measured at T1. Among those with no ICD-10 diagnosis at T0, 8.2% were positive for affective disorders at the 6-month follow-up.
This study suggested that SEGT is effective for breast cancer patients with affective disorders, and indicates the need for prospective evaluations in order to identify those who may develop psychopathology over time.
迄今为止,尚无研究测试过支持表达团体治疗(SEGT)在有既定精神科诊断的癌症患者中的效果。本 6 个月随访研究的目的是评估参加 SEGT 的有 ICD-10 情感综合征诊断的乳腺癌患者和一组无 ICD-10 诊断的乳腺癌患者。
共有 214 名患者在筛查阶段(T0)接受了 ICD-10、简明症状量表(BSI)、癌症心理调整多维量表(Mini-MAC)、多维感知社会支持量表、开放性量表和癌症担忧量表(CWI)的检查。有 ICD-10 情感综合征诊断的患者接受了 16-24 次 SEGT(每次 90 分钟,每周一次),而没有 ICD-10 诊断的患者则接受了随访。两组患者均在 6 个月后(T1)进行了第二次评估。
78 名(36.4%)患者在 T0 时被诊断为 ICD-10 情感综合征,而 127 名(59.4%)未被诊断为任何 ICD-10 诊断。其中,54 名患者参加了 SEGT。在 T1 时,BSI 的所有维度、Mini-MAC 的绝望和焦虑关注子量表、开放性量表和 CWI 均有显著差异。T0 时的任何变量都不是 T1 时 BSI 痛苦的预测因素。在 T0 时没有 ICD-10 诊断的患者中,8.2%在 6 个月随访时被诊断为情感障碍。
本研究表明,SEGT 对有情感障碍的乳腺癌患者有效,并表明需要进行前瞻性评估,以确定那些随着时间的推移可能会发展出精神病理学的患者。