对接受主动监测的前列腺癌患者临床抑郁和焦虑患病率的定量分析。
A quantitative analysis of the prevalence of clinical depression and anxiety in patients with prostate cancer undergoing active surveillance.
作者信息
Watts Sam, Leydon Geraldine, Eyles Caroline, Moore Caroline M, Richardson Alison, Birch Brian, Prescott Philip, Powell Catrin, Lewith George
机构信息
Faculty of Medicine, Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK.
Division of Surgery and Interventional Science, University College London & Department of Urology, UCLH NHS Foundation Trust, London, UK.
出版信息
BMJ Open. 2015 May 22;5(5):e006674. doi: 10.1136/bmjopen-2014-006674.
OBJECTIVE
To quantitatively determine the prevalence of anxiety and depression in men on active surveillance (AS).
DESIGN
Cross-sectional questionnaire survey.
SETTING
Secondary care prostate cancer (PCa) clinics across South, Central and Western England.
PARTICIPANTS
313 men from a total sample of 426 with a histological diagnosis of PCa currently managed with AS were identified from seven UK urology departments. The mean age of respondents was 70 (51-86) years with the majority (76%) being married or in civil partnerships. 94% of responders were of white British ethnicity.
PRIMARY OUTCOME MEASURES
The prevalence of clinically meaningful depression and anxiety as assessed by the Hospital Anxiety and Depression Scale (HADS; score ≥8/21).
SECONDARY OUTCOME MEASURES
Patient demographic data (age, employment, relationship, ethnic and educational status). Each demographic variable was cross-tabulated against patients identified as depressed or anxious to allow for the identification of variables that were significantly associated with depression and anxiety. In order to determine predictors for depression and anxiety among the demographic variables, logistic regression analyses were conducted, with p<0.05 considered as indicating statistical significance.
RESULTS
The prevalence of clinical anxiety and depression as determined via the HADS (HADS ≥8) was 23% (n=73) and 12.5% (n=39), respectively. Published data from men in the general population of similar age has shown prevalence rates of 8% and 6%, respectively, indicating a twofold increase in depression and a threefold increase in anxiety among AS patients. Our findings also suggest that AS patients experience substantially greater levels of anxiety than patients with PCa treated radically. The only demographic predictor for anxiety or depression was divorce.
CONCLUSIONS
Patients with PCa managed with AS experienced substantially higher rates of anxiety and depression than that expected in the general population. Strategies to address this are needed to improve the management of this population and their quality of life.
目的
定量确定接受主动监测（AS）的男性中焦虑和抑郁的患病率。
设计
横断面问卷调查。
背景
英格兰南部、中部和西部的二级护理前列腺癌（PCa）诊所。
参与者
从英国七个泌尿外科部门的426名组织学诊断为PCa且目前接受AS治疗的男性样本中，识别出313名男性。受访者的平均年龄为70（51 - 86）岁，大多数（76%）已婚或处于民事伴侣关系。94%的受访者为英国白人。
主要观察指标
通过医院焦虑抑郁量表（HADS；得分≥8/21）评估的具有临床意义的抑郁和焦虑的患病率。
次要观察指标
患者人口统计学数据（年龄、就业、关系、种族和教育状况）。将每个人口统计学变量与被确定为抑郁或焦虑的患者进行交叉制表，以确定与抑郁和焦虑显著相关的变量。为了确定人口统计学变量中抑郁和焦虑的预测因素，进行了逻辑回归分析，p<0.05被视为具有统计学意义。
结果
通过HADS（HADS≥8）确定的临床焦虑和抑郁的患病率分别为23%（n = 73）和12.5%（n = 39）。来自类似年龄普通人群男性的已发表数据显示患病率分别为8%和6%，这表明AS患者的抑郁患病率增加了两倍，焦虑患病率增加了三倍。我们的研究结果还表明，AS患者的焦虑水平明显高于接受根治性治疗的PCa患者。焦虑或抑郁的唯一人口统计学预测因素是离婚。
结论
接受AS治疗的PCa患者的焦虑和抑郁发生率明显高于普通人群预期。需要采取策略来解决这一问题，以改善对该人群的管理及其生活质量。
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