Pranckeviciene Aiste, Tamasauskas Sarunas, Deltuva Vytenis Pranas, Bunevicius Robertas, Tamasauskas Arimantas, Bunevicius Adomas
Neuroscience Institute, Laboratory of Clinical Research, Lithuanian University of Health Sciences, Eiveniu g. 4, LT-50009, Kaunas, Lithuania.
Department of Neurosurgery, Lithuanian University of Health Sciences, Eiveniu g. 2, LT-50009, Kaunas, Lithuania.
Support Care Cancer. 2016 Jul;24(7):2963-70. doi: 10.1007/s00520-016-3117-2. Epub 2016 Feb 11.
Suicidal ideation (SI) is an important complication in cancer patients that should be promptly recognized and adequately managed. We investigated the prevalence rate and correlates of pre-operative SI in brain tumor (BT) patients admitted for elective BT surgery.
Two hundred and eleven consecutive patients (70 % women; mean age 55.9 ± 15.4 years) scheduled for BT surgery were evaluated for SI ("suicidal thought" item from the Beck Depression Inventory-II), depressive/anxiety symptom severity (Hospital Anxiety and Depression scale (HADS)), health-related quality of life (SF-36 scale), functional status (Barthel Index), and psychiatric histories and treatments. The majority of patients were diagnosed with meningioma (39 %) and high-grade glioma (17 %).
SI was self-reported by 12 (6 %) patients. Patients expressing SI were most commonly diagnosed with meningioma (50 %). Patients with SI were more likely to have a past history of psychiatric disorders, scored higher on the HADS anxiety subscale, and reported worse health-related quality of life across physical and mental health domains. In multivariate regression analyses, worse perceived mental health was associated with increased risk for SI independently from clinical, sociodemographic, and other patient-oriented variables considered in the study.
SI was self-reported by 6 % of BT patients before surgical intervention and was associated with a past history of psychiatric disorders and worse perceived health status. Poor mental health was an independent correlate of SI. The perception of health status by a patient should be considered as an important determinant of poor mental health in BT patients.
自杀观念（SI）是癌症患者的一种重要并发症，应及时识别并妥善处理。我们调查了因择期脑肿瘤（BT）手术入院的BT患者术前SI的患病率及其相关因素。
对211例计划接受BT手术的连续患者（70%为女性；平均年龄55.9±15.4岁）进行SI评估（采用贝克抑郁量表第二版中的“自杀念头”项目）、抑郁/焦虑症状严重程度（医院焦虑抑郁量表（HADS））、健康相关生活质量（SF-36量表）、功能状态（Barthel指数）以及精神病史和治疗情况。大多数患者被诊断为脑膜瘤（39%）和高级别胶质瘤（17%）。
12例（6%）患者自述有SI。表达SI的患者最常见的诊断是脑膜瘤（50%）。有SI的患者更可能有精神疾病既往史，在HADS焦虑分量表上得分更高，并且在身心健康领域报告的健康相关生活质量更差。在多因素回归分析中，较差的心理健康状况与SI风险增加相关，且独立于研究中考虑的临床、社会人口学和其他以患者为导向的变量。
6%的BT患者在手术干预前自述有SI，且与精神疾病既往史和较差的健康状况感知相关。心理健康状况不佳是SI的独立相关因素。患者对健康状况的感知应被视为BT患者心理健康不佳的重要决定因素。
