McFarland Daniel C, Shen Megan Johnson, Polizzi Heather, Mascarenhas John, Kremyanskaya Marina, Holland Jimmie, Hoffman Ronald
Department of Medicine, Memorial Sloan Kettering Cancer Center, West Harrison, NY.
Department of Medicine, Weill Cornell Medicine, New York, NY.
Psychosomatics. 2017 Jan-Feb;58(1):56-63. doi: 10.1016/j.psym.2016.08.006. Epub 2016 Aug 17.
Patients with chronic hematologic malignancies such as myeloproliferative neoplasms suffer from significant physical and psychological symptom burden. This study examined their willingness to accept an antidepressant and their preferences for which provider (mental health professional or hematologist/oncologist) prescribes an antidepressant for the management of anxiety and depression.
Anxiety and depression treatment preferences were measured with 3 questions assessing: (1) willingness to accept an antidepressant, (2) willingness to have their hematologist/oncologist prescribe the antidepressant, and (3) preference for treatment by a psychiatrist or mental health professional. Additionally, the Distress Thermometer and Problem List, Hospital Anxiety and Depression Scale, Risky Families Questionnaire, and demographic information were assessed to assess levels of distress, anxiety, and depression.
Of the 117 participants, 69 (63.0%) were willing to accept an antidepressant in general and 61 (58.1%) were willing to accept an antidepressant from their hematologist/oncologist (p < 0.000). Although 41(39.0%) preferred to be treated by a mental health provider, this preference was not significantly associated with their respective preference for accepting an antidepressant (p = 0.057). Participants already taking antidepressants and those with elevated chronic stress levels were more willing to receive an antidepressant from their hematologist/oncologist (p = 0.035, p = 0.03, respectively). Treatment preferences did not vary based on myeloproliferative neoplasm type, length of time with myeloproliferative neoplasm, race/ethnicity, marital or working status, or by meeting distress/anxiety/depression criteria. A significant minority (n = 28, 26.7%) would not accept any treatment.
Most patients with myeloproliferative neoplasm accepted an antidepressant and readily accepted the prescription from their hematologist/oncologist. The hematologists/oncologist׳s psychopharmacologic knowledge and their willingness to prescribe antidepressants should be assessed.
患有慢性血液系统恶性肿瘤(如骨髓增殖性肿瘤)的患者承受着巨大的身心症状负担。本研究调查了他们接受抗抑郁药的意愿,以及他们对于由哪位医疗服务提供者(心理健康专业人员或血液科医生/肿瘤内科医生)开具抗抑郁药来治疗焦虑和抑郁的偏好。
通过3个问题来测量焦虑和抑郁治疗偏好,这3个问题分别评估:(1)接受抗抑郁药的意愿;(2)让血液科医生/肿瘤内科医生开具抗抑郁药的意愿;(3)对精神科医生或心理健康专业人员治疗的偏好。此外,还评估了痛苦温度计和问题清单、医院焦虑抑郁量表、高危家庭问卷以及人口统计学信息,以评估痛苦、焦虑和抑郁水平。
在117名参与者中,69名(63.0%)总体上愿意接受抗抑郁药,61名(58.1%)愿意接受血液科医生/肿瘤内科医生开具的抗抑郁药(p < 0.000)。尽管41名(39.0%)参与者更倾向于由心理健康服务提供者进行治疗,但这种偏好与他们接受抗抑郁药的相应偏好并无显著关联(p = 0.057)。已经在服用抗抑郁药的参与者以及慢性压力水平较高的参与者更愿意接受血液科医生/肿瘤内科医生开具的抗抑郁药(分别为p = 0.035,p = 0.03)。治疗偏好并不因骨髓增殖性肿瘤类型、患骨髓增殖性肿瘤的时间长短、种族/民族、婚姻或工作状况,或是否符合痛苦/焦虑/抑郁标准而有所不同。有相当一部分人(n = 28,26.7%)不愿意接受任何治疗。
大多数骨髓增殖性肿瘤患者接受抗抑郁药,并欣然接受血液科医生/肿瘤内科医生开具的处方。应评估血液科医生/肿瘤内科医生的精神药理学知识及其开具抗抑郁药的意愿。