Peter MacCullum Cancer Centre, Melbourne, VIC.
Med J Aust. 2010 Sep 6;193(S5):S58-61. doi: 10.5694/j.1326-5377.2010.tb03930.x.
To assess psychosocial distress in patients with early (localised) and advanced (metastatic) prostate cancer (PCA) at diagnosis (Time 1) and 12 months later (Time 2), and identify psychosocial factors predictive of later distress.
DESIGN, PARTICIPANTS AND SETTING: Observational, prospective study of 367 men with early (211) or advanced (156) PCA recruited as consecutive attendees at clinics at seven public hospitals and practices in metropolitan Melbourne between 1 April 2001 and 30 December 2005. Both groups completed questionnaires at Time 1 and Time 2.
Health-related quality of life as assessed by the Short Form 36-item Health Survey; psychological distress, including depression and anxiety as assessed by the Brief Symptom Inventory; and coping patterns as assessed by the Mini-Mental Adjustment to Cancer scale.
Over the 12 months, both the early and advanced PCA group showed reduced vitality and increased depression and anxiety; this effect was greater in the advanced PCA group. Mental health, social functioning and role-emotional functioning also deteriorated in the advanced group. Predictors of depression at Time 2 for the early PCA group were depression, vitality and a fatalistic coping pattern at Time 1; anxiety at Time 2 was predicted by anxiety and vitality at Time 1. In the advanced PCA group, depression at Time 2 was predicted by depression and mental health at Time 1; anxiety at Time 2 was predicted by anxiety, mental health, cognitive avoidance and lower anxious preoccupation at Time 1.
Men with early PCA experience decreasing vitality and increasing psychological distress over the 12 months following diagnosis; this trend is accelerated after diagnosis with advanced PCA. A fatalistic coping pattern at diagnosis of early PCA predicts later depression while cognitive avoidance and lower anxious preoccupation at diagnosis of advanced PCA predict later anxiety.
评估早期（局部）和晚期（转移）前列腺癌（PCA）患者在诊断时（时间 1）和 12 个月后（时间 2）的心理社会困扰，并确定预测后期困扰的心理社会因素。
设计、参与者和设置：2001 年 4 月 1 日至 2005 年 12 月 30 日期间，在墨尔本大都市区的 7 家公立医院和诊所连续就诊的 367 名早期（211 名）或晚期（156 名）PCA 患者进行了观察性、前瞻性研究。两组患者均在时间 1 和时间 2 完成了问卷调查。
采用健康调查简表 36 项健康调查评估健康相关生活质量；采用简明症状量表评估心理困扰，包括抑郁和焦虑；采用癌症心理调整量表评估应对模式。
在 12 个月内，早期和晚期 PCA 组的活力均下降，抑郁和焦虑均增加；晚期 PCA 组的这种影响更大。高级 PCA 组的心理健康、社会功能和角色情感功能也恶化。早期 PCA 组在时间 2 时抑郁的预测因素为时间 1 时的抑郁、活力和宿命论应对模式；时间 2 时的焦虑预测因素为时间 1 时的焦虑和活力。在晚期 PCA 组中，时间 2 时的抑郁预测因素为时间 1 时的抑郁和心理健康；时间 2 时的焦虑预测因素为时间 1 时的焦虑、心理健康、认知回避和焦虑程度较低。
早期 PCA 患者在诊断后 12 个月内经历活力下降和心理困扰增加；这种趋势在诊断为晚期 PCA 后加速。早期 PCA 诊断时的宿命论应对模式预测后期抑郁，而晚期 PCA 诊断时的认知回避和焦虑程度较低预测后期焦虑。
