Blanco-Piñero Nuria, Antequera-Jurado Rosario, Rodríguez-Franco Luis, Ibáñez-Guerra Elena, Herrero-Salado Tomás F, Sánchez-Gómez Serafín
Departamento de Psiquiatría, Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Sevilla, Sevilla, España.
Acta Otorrinolaringol Esp. 2015 Jul-Aug;66(4):210-7. doi: 10.1016/j.otorri.2014.09.006. Epub 2014 Nov 21.
It is unknown if patients who suffer from laryngeal cancer and undergo total laryngectomy experience as much emotional shock and psychological distress as patients with cancers in other locations do. The aim of the study was to identify the incidence of emotional and psychological disorders in laryngectomized patients and describe their symptomatological nuances.
A descriptive cross-sectional study of emotional and psychopathological response of 100 cancer patients undergoing total laryngectomy was performed. The patients were evaluated immediately after surgery (n=35), when initiating communicative rehabilitation (n=23) and 5 years after diagnosis (n=42), versus a control of 55 healthy subjects. Psychopathological assessment battery for anxiety, depression, intrusion, avoidance, arousal and posttraumatic stress disorder consisted of a specific interview, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R).
Laryngectomized patients had low incidence of emotional and psychological disorders such as anxiety (6.9%), depression (5.9%) and/or posttraumatic stress disorder (28.4%), but with sufficient intensity to constitute a psychopathological diagnosis. A significant level of distress was found in 57.4% of patients, with clear diffuse traumatic nature in 52.6% of them, which was more prevalent and intense in the rehabilitation group.
Symptoms of anxiety, depression and posttraumatic stress disorder during different stages after total laryngectomy are not of sufficient intensity and quality to be diagnosable clinical entities; they can be considered an adaptive disorder. The symptoms are less than those of patients with cancer in other locations and appear mostly in the rehabilitation stage, where preventive performances and psychological support should be focused.
喉癌患者接受全喉切除术后所经历的情感冲击和心理困扰是否与其他部位癌症患者相同尚不清楚。本研究的目的是确定全喉切除患者情感和心理障碍的发生率，并描述其症状细微差别。
对100例接受全喉切除术的癌症患者的情感和心理病理反应进行了描述性横断面研究。在术后立即（n = 35）、开始交流康复时（n = 23）和诊断后5年（n = 42）对患者进行评估，并与55名健康受试者作为对照。用于评估焦虑、抑郁、侵入、回避、唤醒和创伤后应激障碍的心理病理评估量表包括一次特定访谈、医院焦虑抑郁量表（HADS）和事件影响量表修订版（IES-R）。
全喉切除患者出现焦虑（6.9%）、抑郁（5.9%）和/或创伤后应激障碍（28.4%）等情感和心理障碍的发生率较低，但强度足以构成心理病理诊断。57.4%的患者存在显著程度的困扰，其中52.6%具有明显的弥漫性创伤性质，在康复组中更为普遍和强烈。
全喉切除术后不同阶段的焦虑、抑郁和创伤后应激障碍症状在强度和性质上不足以构成可诊断的临床实体；可将其视为适应性障碍。这些症状比其他部位癌症患者的症状少，且大多出现在康复阶段，应在此阶段重点开展预防工作和提供心理支持。
