ICR Clinical Trials and Statistics Unit (ICR-CTSU), Section of Clinical Trials, The Institute of Cancer Research, Sir Richard Doll Building, Cotswold Road, Sutton, Surrey SM2 5NG, UK.
Breast. 2010 Apr;19(2):84-91. doi: 10.1016/j.breast.2009.11.007. Epub 2009 Dec 29.
Prospective data are limited on the course of anxiety and depression and their determinants in women with early breast cancer. These parameters were assessed before adjuvant radiotherapy (RT) and over 5 years follow-up. Of 2208 women recruited to the START QOL study, 35% reported clinically relevant levels of anxiety and/or depression pre-RT; there was no significant change in these proportions over time. However, 75% women with high baseline anxiety recorded further high scores over time whilst one in six had high scores at every follow-up point. Depression showed a similar pattern with lower frequencies at all time points; very few with initial normal scores developed clinically relevant anxiety or depression over time. Lower educational level predicted worse anxiety and depression over time; younger age predicted worse anxiety and chemotherapy predicted worse depression. Scores in the borderline or case range for anxiety or depression at baseline were both significantly associated with worse mood states over 5 years. These findings indicate the course of anxiety and depression in women with specific risk factors. This subgroup of patients requires greater clinical attention.
前瞻性数据有限，无法确定早期乳腺癌女性的焦虑和抑郁及其决定因素的发展过程。这些参数在辅助放疗 (RT) 前和 5 年随访期间进行评估。在 START QOL 研究中招募的 2208 名女性中，35%的女性报告在 RT 前存在临床相关水平的焦虑和/或抑郁；随着时间的推移，这些比例没有明显变化。然而，75%基线焦虑水平较高的女性在随访期间记录到进一步的高分，而六分之一的女性在每个随访点都有高分。抑郁呈现出类似的模式，所有时间点的频率都较低；很少有初始正常评分的人随着时间的推移发展为临床相关的焦虑或抑郁。较低的教育水平预示着焦虑和抑郁随着时间的推移而恶化；年龄越小，焦虑越严重，化疗预示着抑郁越严重。基线时焦虑或抑郁处于边界或病例范围内的评分都与 5 年内的情绪状态恶化显著相关。这些发现表明了具有特定风险因素的女性焦虑和抑郁的发展过程。这一小部分患者需要更多的临床关注。
