Vehling S, Mehnert A, Hartmann M, Oing C, Bokemeyer C, Oechsle K
Department of Medical Psychology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany.
Department of Medical Psychology, University Medical Center Hamburg, Eppendorf, Hamburg, Germany; Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Germany.
Gen Hosp Psychiatry. 2016 Jan-Feb;38:21-5. doi: 10.1016/j.genhosppsych.2015.09.001. Epub 2015 Sep 8.
Despite a good prognosis, the typically young age at diagnosis and physical sequelae may cause psychological distress in germ cell tumor survivors. We aimed to determine the frequency of anxiety and depression and analyze the impact of demographic and disease-related factors.
We enrolled N=164 testicular germ cell tumor survivors receiving routine follow-up care at the University Cancer Center Hamburg and a specialized private practice (mean, 11.6 years after diagnosis). Patients completed the Generalized Anxiety Disorder Screener-7, the Patient Health Questionnaire-9 and the Memorial Symptom Assessment Scale-Short Form.
We found clinically significant anxiety present in 6.1% and depression present in 7.9% of survivors. A higher number of physical symptoms and having children were significantly associated with higher levels of both anxiety and depression in multivariate regression analyses controlling for age at diagnosis, cohabitation, socioeconomic status, time since diagnosis, metastatic disease and relapse. Younger age at diagnosis and shorter time since diagnosis were significantly associated with higher anxiety.
Although rates of clinically relevant anxiety and depression were comparably low, attention toward persisting physical symptoms and psychosocial needs related to a young age at diagnosis and having children will contribute to address potential long-term psychological distress in germ cell tumor survivors.
尽管生殖细胞肿瘤幸存者预后良好，但诊断时的典型年轻年龄和身体后遗症可能会导致心理困扰。我们旨在确定焦虑和抑郁的发生率，并分析人口统计学和疾病相关因素的影响。
我们招募了164名在汉堡大学癌症中心和一家专门的私人诊所接受常规随访的睾丸生殖细胞肿瘤幸存者（诊断后平均11.6年）。患者完成了广泛性焦虑障碍筛查量表-7、患者健康问卷-9和纪念症状评估量表简表。
我们发现6.1%的幸存者存在具有临床意义的焦虑，7.9%的幸存者存在抑郁。在控制诊断年龄、同居情况、社会经济地位、诊断后时间、转移性疾病和复发的多变量回归分析中，更多的身体症状和有子女与更高水平的焦虑和抑郁显著相关。诊断时年龄较小和诊断后时间较短与更高的焦虑显著相关。
尽管具有临床相关性的焦虑和抑郁发生率相对较低，但关注持续存在的身体症状以及与诊断时年轻年龄和有子女相关的心理社会需求，将有助于解决生殖细胞肿瘤幸存者潜在的长期心理困扰。
