Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Germany.
Support Care Cancer. 2011 Nov;19(11):1797-805. doi: 10.1007/s00520-010-1021-8. Epub 2010 Oct 15.
The aim of this study was to examine the prevalence of comorbid mental disorders as well as the extent of psychosocial distress in patients with intracranial tumours and their partners during the early treatment phase. Moreover, we aimed to identify which events are experienced as most distressing in the context of the early diagnosis of brain cancer by patients and spouses.
Structured clinical interviews for DSM-IV (SCID-IV) were conducted with 26 patients and their partners after the first neurosurgical treatment within the first 3 months after the detection of a brain tumour. Screening measures (NCCN distress thermometer, HADS, IES-R) were used to assess the extent of psychosocial distress as well as anxiety, depression and traumatic stress responses. Distressing experiences were assessed via a structured questionnaire and interview.
Thirty-eight per cent of the patients and 47% of the partners suffered from a psychiatric disorder. Most frequent diagnoses were adjustment disorder and acute stress disorder. The majority of the participants suffered from elevated psychosocial distress. Partners were equally or even more affected than the patients. For the patients, the experience most frequently described as distressing was the first detection of the tumour. The majority of the partners reported to be distressed by the fear of surgery outcomes.
This study revealed that during this very first treatment phase, both brain tumour patients and their spouses show a high prevalence of comorbid mental disorders and psychosocial distress. The findings suggest that research and clinical efforts are needed to address the psychosocial concerns of these populations.
本研究旨在检查颅内肿瘤患者及其配偶在早期治疗阶段同时患有精神障碍的患病率,以及他们的心理社会压力程度。此外,我们旨在确定患者和配偶在脑癌早期诊断时所经历的哪些事件最具压力。
在脑肿瘤发现后 3 个月内首次神经外科治疗后,对 26 名患者及其配偶进行了 DSM-IV(SCID-IV)的结构性临床访谈。使用 NCCN 痛苦温度计、HADS、IES-R 等筛选措施来评估心理社会压力程度,以及焦虑、抑郁和创伤后应激反应程度。通过结构化问卷和访谈评估压力体验。
38%的患者和 47%的配偶患有精神障碍。最常见的诊断是适应障碍和急性应激障碍。大多数参与者的心理社会压力较大。配偶受到的影响与患者相当,甚至更大。对于患者来说,最常描述为有压力的体验是第一次发现肿瘤。大多数伴侣表示对手术结果的恐惧感到不安。
本研究表明,在这一最早的治疗阶段,脑肿瘤患者及其配偶都表现出精神障碍和心理社会压力的高患病率。这些发现表明,需要研究和临床努力来解决这些人群的心理社会问题。