Oerlemans Simone, Mols Floortje, Nijziel Marten R, Zijlstra Wobbe P, Coebergh Jan Willem W, van de Poll-Franse Lonneke V
Research Department, Comprehensive Cancer Centre the Netherlands, PO Box 231, 5600 AE, Eindhoven, The Netherlands,
J Cancer Surviv. 2014 Dec;8(4):555-64. doi: 10.1007/s11764-014-0367-1. Epub 2014 May 13.
The purpose of this study is to prospectively assess anxiety and depression among patients with Hodgkin lymphoma (HL) and diffuse large B cell lymphoma (DLBCL). Also, to compare its prevalence with a normative population, identify subgroups with more anxiety and depression, and assess its impact on health-related quality of life (HRQoL).
The population-based Eindhoven Cancer Registry was used to select patients diagnosed with HL or DLBCL from 1999 to 2010, 489 responded (T1). The HADS was completed four times (T1-T4), with a 1-year interval. Linear mixed-models were used to assess the course of anxiety and depression and identify high-risk subgroups.
Both anxiety and depression were reported more often by patients compared to the normative population (p < 0.05). Over the four time points, approximately 10% of patients reported to be always and 15% reported to be sometimes anxious or depressed. Anxiety and depression did not improve in time. Patients with comorbidity and patients who were lower educated reported higher anxiety and depression scores (p < 0.05). Younger DLBCL patients reported higher anxiety scores, whereas older DLBCL patients reported higher depression scores over time (p < 0.05). Global health status/HRQoL was clinically relevant lower in patients with anxiety and depression and this appeared to be constant over time.
More HL and DLBCL patients experience anxiety and depression compared to their counterparts in the general population and it did not improve in time.
Clinicians should be aware that former lymphoma patients with anxiety and depression have a deteriorated global health status/HRQoL and refer patients to suitable aftercare when necessary.
本研究旨在前瞻性评估霍奇金淋巴瘤（HL）和弥漫性大B细胞淋巴瘤（DLBCL）患者的焦虑和抑郁情况。此外，将其患病率与正常人群进行比较，确定焦虑和抑郁程度较高的亚组，并评估其对健康相关生活质量（HRQoL）的影响。
利用基于人群的埃因霍温癌症登记处，选取1999年至2010年期间诊断为HL或DLBCL的患者，489人做出回应（T1）。采用医院焦虑抑郁量表（HADS）进行四次评估（T1 - T4），间隔为1年。使用线性混合模型评估焦虑和抑郁的病程，并确定高危亚组。
与正常人群相比，患者报告的焦虑和抑郁情况更为常见（p < 0.05）。在四个时间点上，约10%的患者报告一直存在焦虑或抑郁，15%的患者报告有时存在焦虑或抑郁。焦虑和抑郁情况并未随时间改善。合并症患者和受教育程度较低的患者报告的焦虑和抑郁得分更高（p < 0.05）。随着时间推移，年轻的DLBCL患者报告的焦虑得分更高，而年长的DLBCL患者报告的抑郁得分更高（p < 0.05）。焦虑和抑郁患者的总体健康状况/HRQoL在临床上显著较低，且随时间似乎保持不变。
与普通人群相比，更多的HL和DLBCL患者经历焦虑和抑郁，且情况未随时间改善。
临床医生应意识到，患有焦虑和抑郁的 former淋巴瘤患者总体健康状况/HRQoL恶化，必要时应将患者转介至适当的后续护理。
