Zhang Jia-Kui, Fang Li-Li, Zhang De-Wei, Jin Qiu, Wu Xiao-Mei, Liu Ji-Chao, Zhang Chun-Dong, Dai Dong-Qiu
Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
J Pain Symptom Manage. 2016 Jul;52(1):81-91. doi: 10.1016/j.jpainsymman.2015.12.342. Epub 2016 Apr 23.
The associations between Type D personality and poor quality of life, overall survival, and mental health in gastric cancer survivors.
The aim of this research was to explore quality of life (QoL), mental health status, Type D personality, symptom duration, and emergency admissions of Chinese gastric cancer patients, as well as the relationship between these factors.
Eight hundred thirty eligible Chinese patients newly diagnosed with gastric cancer between July 2009 and July 2011 were enrolled in this prospective study. Type D personality was measured with the 14-item Type D Personality Scale (DS14). Mental health status was measured with the Hospital Anxiety and Depression Scale. The QoL outcomes were assessed longitudinally using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and Quality of Life Questionnaire-STO22 at baseline and six months after diagnosis.
The proportion of patients with symptom duration of more than one month and who were diagnosed after emergency admissions in the Type D group was significantly higher than that in the non-Type D personality group. At both of the time points, Type D patients reported statistically significant lower scores on role, emotional, cognitive, and social functioning (all Ps < 0.001) functional scales, global health status/QoL scales (P < 0.001), and worse symptom scores compared to patients without a Type D personality. During the six-month time frame, a higher percentage of patients in the Type D group demonstrated a considerable QoL deterioration. Clinically elevated levels of anxiety and depression were more prevalent in Type D than in non-Type D survivors (both Ps < 0.001). There was a statistically significant difference in three-year overall survival between the patients in the Type D group and the non-Type D personality group.
Type D personality is associated with poor QoL, three-year overall survival and mental health status among survivors of gastric cancer, even after adjustment of confounding background variables. The Type D personality group experienced increased levels of pain and fatigue compared to non-Type D patients. Type D personality might be a general vulnerability factor to screen for subgroups at risk of longer symptom duration and emergency admissions in clinical practice.
D型人格与胃癌幸存者生活质量差、总生存期及心理健康之间的关联。
本研究旨在探讨中国胃癌患者的生活质量（QoL）、心理健康状况、D型人格、症状持续时间及急诊入院情况，以及这些因素之间的关系。
选取2009年7月至2011年7月期间新诊断的830例符合条件的中国胃癌患者纳入本前瞻性研究。采用14项D型人格量表（DS14）测量D型人格。使用医院焦虑抑郁量表测量心理健康状况。在基线和诊断后6个月，纵向使用欧洲癌症研究与治疗组织生活质量问卷核心30版和生活质量问卷STO22评估生活质量结果。
D型人格组症状持续时间超过1个月且经急诊入院后确诊的患者比例显著高于非D型人格组。在两个时间点，与非D型人格患者相比，D型人格患者在角色、情感、认知和社会功能（所有P<0.001）功能量表、总体健康状况/QoL量表（P<0.001）上的得分在统计学上显著较低，且症状得分更差。在6个月的时间范围内，D型人格组中相当比例的患者生活质量出现显著恶化。临床上，D型人格幸存者中焦虑和抑郁水平升高的情况比非D型人格幸存者更为普遍（两者P<0.001）。D型人格组患者与非D型人格组患者的三年总生存期存在统计学显著差异。
即使在调整混杂背景变量后，D型人格仍与胃癌幸存者的生活质量差、三年总生存期及心理健康状况相关。与非D型人格患者相比，D型人格组患者的疼痛和疲劳水平更高。在临床实践中，D型人格可能是一个普遍的易患因素，用于筛查症状持续时间较长和有急诊入院风险的亚组。
