Department of Neuro-Oncology, MDACC, 1515 Holcombe Blvd, Houston, TX 77030, USA.
J Neurooncol. 2013 Jul;113(3):505-12. doi: 10.1007/s11060-013-1143-1. Epub 2013 May 16.
Patients diagnosed with primary brain tumors such as glioma experience psychological distress throughout the illness trajectory. Determining which patient characteristics are associated with more severe mood disturbance throughout the illness trajectory can help identify patients at risk and assist in developing targeted interventions based on these factors. Adult glioma patients were eligible for participation. Data collection tools included an investigator completed clinician assessment tool, patient completed demographic form and the Profile of mood states-short form. A multiple regression model was used to describe the relationship between the patient groups and clinical factors. The study enrolled 186 glioma patients of various tumor grades, who were categorized in three groups (newly diagnosed, on-treatment, follow-up) based on disease status at time of visit. Newly diagnosed patients experienced more total mood disturbance than all the other groups. Characteristics associated with more severe mood disturbance varied by patient group: newly diagnosed patients who were not on corticosteroids and were not married were more likely to have higher mood disturbance [R(2) = 0.27, F (2, 29) = 5.31, p < 0.02]. For those on treatment, the use of concomitant medications, having more than 1 recurrence and low income predicted higher mood disturbance [R(2) = 0.417, F (4, 67) = 11.98, p < 0.001]. For those not on active treatment, female sex, anti-depressant use and having a lower income was associated with higher mood disturbance [R(2) = 0.183, F (3, 55) = 4.11, p < 0.02]. Additionally, when compared to other cancer groups, glioma patients reported similar mood disturbance to those with breast cancer. Factors other than disease characteristics are associated with higher mood disturbance and vary according to current disease status. The use of concomitant medications, demographic factors, recurrence and income are associated with mood disturbance and interventions may need to be tailored to these underlying factors.
患有原发性脑肿瘤(如神经胶质瘤)的患者在整个疾病过程中都会经历心理困扰。确定哪些患者特征与整个疾病过程中更严重的情绪障碍相关,可以帮助识别处于风险中的患者,并根据这些因素制定有针对性的干预措施。成年神经胶质瘤患者有资格参加此项研究。数据收集工具包括研究者完成的临床医生评估工具、患者完成的人口统计学表格和状态-特质焦虑问卷简表。使用多元回归模型来描述患者群体和临床因素之间的关系。该研究共纳入了 186 名不同肿瘤分级的神经胶质瘤患者,他们根据就诊时的疾病状态分为三组(新诊断、治疗中、随访)。新诊断的患者比其他所有组的患者经历了更多的总体情绪困扰。与更严重的情绪困扰相关的特征因患者群体而异:未服用皮质类固醇且未婚的新诊断患者更有可能出现更高的情绪困扰[R²=0.27,F(2,29)=5.31,p<0.02]。对于正在治疗的患者,同时使用其他药物、复发次数多于 1 次和收入较低预测会出现更高的情绪困扰[R²=0.417,F(4,67)=11.98,p<0.001]。对于未接受积极治疗的患者,女性、使用抗抑郁药和收入较低与更高的情绪困扰相关[R²=0.183,F(3,55)=4.11,p<0.02]。此外,与其他癌症群体相比,神经胶质瘤患者的情绪困扰与乳腺癌患者相似。除了疾病特征之外,其他因素也与更高的情绪困扰相关,且根据当前的疾病状况而有所不同。同时使用其他药物、人口统计学因素、复发和收入与情绪困扰相关,干预措施可能需要针对这些潜在因素进行定制。