Mielcarek Piotr, Nowicka-Sauer Katarzyna, Kozaka Joanna
a Intermed Gynecology Clinic , Gdańsk , Poland .
b Department of Family Medicine , Medical University of Gdańsk , Gdańsk , Poland , and.
J Psychosom Obstet Gynaecol. 2016;37(2):57-67. doi: 10.3109/0167482X.2016.1141891. Epub 2016 Mar 3.
Survival of ovarian cancer patients is still unsatisfactory despite the introduction of new diagnostic and therapeutic methods. Women with advanced ovarian cancer with long-term survival are at persistent risk of anxiety and reactive depression due to poor prognosis and risk of burdensome symptoms. The aim of the study was to assess changes in anxiety and depression during multimodality ovarian cancer treatment and to identify correlates of anxiety and depression.
The study included 106 consecutive patients with advanced ovarian cancer. Mean age of the study group was 53.9 years (SD = 10.8, range: 23-79). The participants completed Hospital Anxiety and Depression Scale and State-Trait Anxiety Inventory four times: prior to and one week after surgery, and before the second and the fourth course of adjuvant chemotherapy. Multivariate analysis was performed to identify the independent determinants of distress at various stages of treatment.
The level of anxiety and the prevalence of pathological anxiety (74%) were the highest prior to surgery and gradually decreased thereafter. Irrespective of the treatment stage, the level of anxiety was higher than the corresponding level of depression. History of abortion, presence of intestinal stoma, poor general status, residual disease and time from the initial diagnosis were the main determinants of distress in ovarian cancer patients.
Significant changes in the level of anxiety and slight fluctuations in the depression level experienced during ovarian cancer treatment are mostly determined by clinical variables. Identification of individuals with psychological comorbidities is a vital component of patient-oriented multidisciplinary care.
尽管引入了新的诊断和治疗方法，但卵巢癌患者的生存率仍不尽人意。晚期卵巢癌长期存活的女性由于预后不良和出现令人负担沉重症状的风险，持续面临焦虑和反应性抑郁的风险。本研究的目的是评估多模式卵巢癌治疗期间焦虑和抑郁的变化，并确定焦虑和抑郁的相关因素。
该研究纳入了106例连续的晚期卵巢癌患者。研究组的平均年龄为53.9岁（标准差=10.8，范围：23 - 79岁）。参与者在四个时间点完成医院焦虑抑郁量表和状态-特质焦虑问卷：手术前、手术后一周、辅助化疗第二疗程前以及第四疗程前。进行多变量分析以确定治疗各阶段困扰的独立决定因素。
焦虑水平及病理性焦虑的患病率（74%）在手术前最高，此后逐渐下降。无论治疗阶段如何，焦虑水平均高于相应的抑郁水平。流产史、肠造口的存在、一般状况差、残留病灶以及自初次诊断以来的时间是卵巢癌患者困扰的主要决定因素。
卵巢癌治疗期间焦虑水平的显著变化以及抑郁水平的轻微波动主要由临床变量决定。识别有心理合并症的个体是以患者为导向的多学科护理的重要组成部分。
