Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, OH 43210, USA.
Psychooncology. 2013 Aug;22(8):1889-94. doi: 10.1002/pon.3233. Epub 2012 Dec 17.
A cancer diagnosis provokes significant levels of emotional distress, with intrusive thoughts being the most common manifestation among breast cancer survivors. Cancer-related intrusive thoughts can take the form of emotional memories, flashbacks, nightmares, and intrusive images. Emotional arousal after a severe life stressor prolongs adrenergic activation, which in turn may increase risk for post-traumatic symptomatology. However, antihypertensive beta-blockers block adrenergic activation and are known to reduce traumatic memories and related psychological distress. Thus, the current study examined the association between beta-blocker use and the severity of cancer-related intrusive thoughts and related symptoms following a cancer diagnosis.
The 174 breast and 36 female colorectal cancer patients who had recently undergone diagnostic screening or biopsy included 39 beta-blocker users and 171 non-users. Prior to any cancer treatment including surgery, participants completed questionnaires that included the Impact of Events Scale and the Center for Epidemiological Studies Depression Scale. Analyses controlled for age, education, cancer stage, cancer type, days since diagnosis, marital status, depression, and comorbidities.
Although the high rates of cancer-related distress in this sample were similar to those of other studies with recently diagnosed patients, beta-blocker users endorsed 32% fewer cancer-related intrusive thoughts than non-users.
Recently diagnosed cancer patients using beta-blockers reported less cancer-related psychological distress. These results suggest that beta-blocker use may benefit cancer patients' psychological adjustment following diagnosis, and provide a promising direction for future investigations on the pharmacological benefits of beta-blockers for cancer-related distress.
癌症诊断会引起明显的情绪困扰,其中侵入性思维是乳腺癌幸存者中最常见的表现。与癌症相关的侵入性思维可以表现为情绪记忆、闪回、噩梦和侵入性图像。严重生活应激源后的情绪唤醒会延长肾上腺素能激活,从而可能增加创伤后症状的风险。然而,降压β受体阻滞剂可阻断肾上腺素能激活,并且已知可减少创伤性记忆和相关心理困扰。因此,本研究探讨了β受体阻滞剂的使用与癌症诊断后癌症相关侵入性思维的严重程度以及相关症状之间的关联。
174 名接受过诊断性筛查或活检的乳腺癌和 36 名女性结直肠癌患者,包括 39 名β受体阻滞剂使用者和 171 名非使用者。在包括手术在内的任何癌症治疗之前,参与者完成了包括事件影响量表和流行病学研究中心抑郁量表在内的问卷。分析控制了年龄、教育程度、癌症分期、癌症类型、诊断后天数、婚姻状况、抑郁和合并症。
尽管该样本中与癌症相关的困扰率很高,与其他最近诊断为癌症患者的研究相似,但β受体阻滞剂使用者报告的与癌症相关的侵入性思维比非使用者少 32%。
最近被诊断为癌症的使用β受体阻滞剂的患者报告的与癌症相关的心理困扰较少。这些结果表明,β受体阻滞剂的使用可能有益于癌症患者诊断后的心理调整,并为未来对β受体阻滞剂治疗与癌症相关的困扰的药理学益处的研究提供了有前途的方向。