Department of Psychology, Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City Veterans Affairs (VA) Medical Center, Iowa City, IA 52242, USA.
Health Psychol. 2010 Jan;29(1):65-71. doi: 10.1037/a0017788.
Symptoms of depression are common in those with cancer. The authors investigated whether depressive symptoms assessed before the initiation of cancer treatment predicted diminished health-related quality of life (HRQOL) at follow-up.
As part of a large, prospective study of oncologic outcomes, 306 patients with head and neck cancer (HNC) were assessed on several clinical and psychosocial characteristics during a pretreatment clinic visit and then at 3- and 12-month follow-up appointments.
Depressive symptomatology was assessed with the Beck Depression Inventory and HNC-specific HRQOL (main outcome measure) was assessed with the Head and Neck Cancer Inventory.
Controlling for age, gender, marital status, cancer site, stage of disease, alcohol and tobacco use, comorbidity status, and pretreatment HRQOL, simultaneous multiple regression analyses revealed that depressive symptoms present at study enrollment, before the initiation of cancer treatment, significantly predicted lower HRQOL at 3- and 12-month follow-up assessments across the 4 HNC-specific domains of speech, eating, aesthetics, and social disruption (all ps <or= .01).
Results suggest that depressive symptomatology present near the time of diagnosis can have a significant, deleterious impact on HRQOL over time in HNC survivors. Thus, it may be useful to assess depression at diagnosis to identify individuals at greater risk for poor HRQOL outcomes.
癌症患者常伴有抑郁症状。作者研究了癌症治疗前评估的抑郁症状是否预示着随访时健康相关生活质量（HRQOL）下降。
作为一项大型头颈部癌症（HNC）肿瘤学结果前瞻性研究的一部分，306 例 HNC 患者在治疗前的临床就诊期间接受了几项临床和社会心理特征评估，然后在 3 个月和 12 个月的随访预约时进行评估。
采用贝克抑郁量表评估抑郁症状，采用头颈部癌症量表评估 HNC 特定的 HRQOL（主要观察指标）。
控制年龄、性别、婚姻状况、癌症部位、疾病分期、酒精和烟草使用、合并症状况以及治疗前的 HRQOL，同步多元回归分析显示，研究入组时、癌症治疗前出现的抑郁症状显著预测了 3 个月和 12 个月随访时 4 个 HNC 特定领域（言语、进食、美观和社会障碍）的 HRQOL 下降（均 p <.01）。
结果表明，诊断时出现的抑郁症状可能会对 HNC 幸存者的 HRQOL 产生显著的、有害的长期影响。因此，在诊断时评估抑郁症状可能有助于识别那些 HRQOL 结局较差的个体。
