Hunter M S, Stefanopoulou E
a Department of Psychology , Institute of Psychiatry, Psychology and Neuroscience, King's College London , London , UK.
Climacteric. 2016;19(1):91-7. doi: 10.3109/13697137.2015.1125460. Epub 2015 Dec 16.
Hot flushes and night sweats (HFNS) are common but under-researched in prostate cancer survivors undergoing androgen-deprivation therapy (ADT). We aimed to examine subjective reports and physiological measures of HFNS, and the influence of sociodemographic, clinical and psychological factors on HFNS in men undergoing ADT.
Sixty-eight men undergoing ADT for prostate cancer attended an assessment interview, completed questionnaires (assessing HFNS frequency and problem-rating, mood, stress, optimism, somatosensory amplification, HFNS beliefs/behaviors) and wore an ambulatory sternal skin conductance (SSC) monitor for 48 h.
The sample had a mean age of 69.76 (standard deviation, SD = 8.04) years, were on average 27.24 (SD = 28.53) months since cancer diagnosis and had been on their current ADT regime for 16 months (range 2-74 months). The men reported frequent (weekly mean 51.04, SD = 33.21) and moderately problematic HFNS. Overall, 294 (20%) of the SSC-defined HFNS were concordant with prospective frequency (event marker), while 63% were under-reported and 17% were over-reported, under-reporting being more common than over-reporting. There were no significant predictors of HFNS frequency (subjective or physiological measures), but psychological variables (HFNS beliefs and behaviors (β = 0.56, p < 0.03), anxiety (β = 0.24, p < 0.01) and somatic amplification (β = 0.76, p < 0.04) were the main predictors of problematic HFNS, i.e. troublesome symptoms.
These results are consistent with those of studies of women during menopause and breast cancer survivors, i.e. subjective and physiological measures appear to identify different HFNS dimensions. Psychological variables (HFNS beliefs and behaviors, anxiety and somatic amplification) can be targeted, using cognitive behavior therapy, for symptom relief.
潮热和盗汗(HFNS)在接受雄激素剥夺治疗(ADT)的前列腺癌幸存者中很常见,但相关研究较少。我们旨在研究HFNS的主观报告和生理指标,以及社会人口学、临床和心理因素对接受ADT治疗的男性HFNS的影响。
68名接受前列腺癌ADT治疗的男性参加了评估访谈,完成了问卷调查(评估HFNS频率和问题评分、情绪、压力、乐观程度、体感放大、HFNS信念/行为),并佩戴动态胸骨皮肤电导(SSC)监测仪48小时。
样本的平均年龄为69.76岁(标准差,SD = 8.04),自癌症诊断以来平均为27.24个月(SD = 28.53),目前接受ADT治疗的时间为16个月(范围2 - 74个月)。这些男性报告HFNS频繁(每周平均51.04次,SD = 33.21)且问题程度中等。总体而言,SSC定义的HFNS中有294次(20%)与预期频率(事件标记)一致,而63%报告不足,17%报告过度,报告不足比报告过度更常见。HFNS频率(主观或生理指标)没有显著的预测因素,但心理变量(HFNS信念和行为(β = 0.56,p < 0.03)、焦虑(β = 0.24,p < 0.01)和躯体放大(β = 0.76,p < 0.04))是有问题的HFNS(即麻烦症状)的主要预测因素。
这些结果与绝经期间女性和乳腺癌幸存者的研究结果一致,即主观和生理指标似乎能识别HFNS的不同维度。心理变量(HFNS信念和行为、焦虑和躯体放大)可以通过认知行为疗法来针对性缓解症状。