癌症患者的抑郁与临终关怀
Depression and end-of-life care for patients with cancer.
作者信息
Rosenstein Donald L
机构信息
Comprehensive Cancer Support Program, Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina 27599-7305, USA.
出版信息
Dialogues Clin Neurosci. 2011;13(1):101-8. doi: 10.31887/DCNS.2011.13.1/drosenstein.
Abstract
Patients with cancer and depression experience more physical symptoms, have poorer quality of life, and are more likely to have suicidal thoughts or a desire for hastened death than are cancer patients who are not depressed. Despite the ubiquity of depressive symptoms in cancer patients at the end of life, critical questions remain unanswered with respect to etiopathogenesis, diagnosis, and treatment of depression in these vulnerable patients. The pharmacotherapy of depression in patients with advanced cancer should be guided by a palliative care approach focused on symptom reduction, irrespective of whether the patient meets diagnostic criteria for major depression. Earlier and more intensive supportive care for patients with cancer reduces symptom burden and may prolong life for patients with advanced disease. Symptom-oriented clinical trials are needed to improve end-of-life cancer care.
摘要
与未患抑郁症的癌症患者相比，患有癌症和抑郁症的患者会经历更多身体症状，生活质量更差，并且更有可能出现自杀念头或渴望加速死亡。尽管临终癌症患者中抑郁症状普遍存在，但关于这些脆弱患者抑郁症的病因、诊断和治疗等关键问题仍未得到解答。晚期癌症患者抑郁症的药物治疗应以减轻症状的姑息治疗方法为指导，无论患者是否符合重度抑郁症的诊断标准。对癌症患者更早、更强化的支持性护理可减轻症状负担，并可能延长晚期疾病患者的生命。需要开展以症状为导向的临床试验，以改善临终癌症护理。
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