Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.
Psychooncology. 2013 Jul;22(7):1581-6. doi: 10.1002/pon.3170. Epub 2012 Aug 31.
The aim of this study was to assess the levels and sources of distress in patients with lymphoma. This study also focused on the influence of factors of the level of distress and the cutoff score using the Distress Thermometer (DT) relative to the Hospital Anxiety and Depression Scale (HADS).
DT and HADS were used to estimate the psychological status of 323 eligible lymphoma patients. The DT was evaluated against the HADS for its sensitivity and specificity.
One hundred and ninety-three (59.7%) lymphoma patients experienced overall distress on the HADS, with 137 (42.4%) experiencing anxiety and 114 (35.3%) suffering from depression. There were 199 (61.6%) and 163 (50.5%) patients with distress score ≥ 4 and ≥ 5, respectively. DT was significantly correlated with the HADS-total (T) (r=0.820, p<0.001), HADS-depression (D) (r=0.763, p<0.001), and HADS-anxiety (A) (r=0.738, p<0.001). The consistency of the DT and HADS was favorable (coherence index=0.6030, p<0.01) when the cutoff score was 5 for the DT. Referring to the cutoff of 15 on HADS, 5 on DT yielded optimal specificity (0.869, p<0.001) and sensitivity (0.756, p<0.001). In multiple logistic regression analysis, patients with 'B symptoms' were more likely to have a distress score ≥ 5 [OR=4.512, p<0.05, 95% CI 1.953-10.467].
DT is efficacious for screening for anxiety and depression in lymphoma patients.
本研究旨在评估淋巴瘤患者的痛苦程度及其来源。本研究还重点关注了使用痛苦温度计(DT)评估的痛苦水平的影响因素和相对于医院焦虑抑郁量表(HADS)的截断分数。
使用 DT 和 HADS 评估 323 名符合条件的淋巴瘤患者的心理状态。评估 DT 的敏感性和特异性与 HADS 相对应。
193 名(59.7%)淋巴瘤患者在 HADS 上表现出总体痛苦,其中 137 名(42.4%)患有焦虑症,114 名(35.3%)患有抑郁症。分别有 199 名(61.6%)和 163 名(50.5%)患者的痛苦评分分别≥4 和≥5。DT 与 HADS 总分(T)(r=0.820,p<0.001)、HADS 抑郁(D)(r=0.763,p<0.001)和 HADS 焦虑(A)(r=0.738,p<0.001)显著相关。当 DT 的截断值为 5 时,DT 与 HADS 的一致性较好(一致性指数=0.6030,p<0.01)。参考 HADS 的 15 截断值,DT 的 5 截断值具有最佳的特异性(0.869,p<0.001)和敏感性(0.756,p<0.001)。在多因素逻辑回归分析中,具有“B 症状”的患者更有可能出现痛苦评分≥5[OR=4.512,p<0.05,95%CI 1.953-10.467]。
DT 是一种有效的筛查淋巴瘤患者焦虑和抑郁的工具。