Caruso R, Nanni M G, Riba M, Sabato S, Mitchell A J, Croce E, Grassi L
a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.
b University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders , S. Anna University Hospital and Health Authorities , Ferrara , Italy.
Acta Oncol. 2017 Feb;56(2):146-155. doi: 10.1080/0284186X.2016.1266090. Epub 2017 Jan 31.
Although depression and mood-related disorders are common in persons with cancer, these conditions remain frequently overlooked in clinical practice. Negative consequences of depressive disorder spectrum have been reported (e.g. suicidal ideation, increase physical complications and somatic symptoms, negative influence on prognosis), indicating the need for routine screening, assessment and management.
A search of the major databases (Medline, Embase, PsycLIT, PsycINFO, and the Cochrane Library) was conducted on the reviews and meta-analyses available in order to summarize relevant data concerning depressive disorders spectrum in terms of prevalence, risk factors, and screening and assessment among patients with cancer across the trajectory of the disease.
The data show a prevalence of depression and depressive disorders between 5% and 60% according to the different diagnostic criteria, the tools used in the studies (e.g. semi-structured psychiatric interview and psychometric questionnaires), as well as the stage and type of cancer. Furthermore, despite the significant health care resources devoted to cancer care and the importance of addressing depressive symptoms, assessment and management of depressive spectrum disorders in cancer patients remains suboptimal.
Routine screening and adequate assessment of depressive spectrum disorders is necessary in patients with cancer in order to effectively manage the multifaceted and complex consequences on cancer care.
尽管抑郁症及与情绪相关的障碍在癌症患者中很常见,但在临床实践中这些情况仍常常被忽视。已有报道指出抑郁障碍谱系的负面后果(如自杀意念、身体并发症和躯体症状增加、对预后产生负面影响),这表明有必要进行常规筛查、评估和管理。
检索主要数据库(Medline、Embase、PsycLIT、PsycINFO和Cochrane图书馆)中现有的综述和荟萃分析,以便总结关于癌症患者在疾病发展过程中抑郁障碍谱系在患病率、危险因素以及筛查和评估方面的相关数据。
数据显示,根据不同的诊断标准、研究中使用的工具(如半结构化精神科访谈和心理测量问卷)以及癌症的阶段和类型,抑郁症和抑郁障碍的患病率在5%至60%之间。此外,尽管投入了大量医疗资源用于癌症护理,且解决抑郁症状很重要,但癌症患者抑郁谱系障碍的评估和管理仍不尽人意。
对癌症患者进行抑郁谱系障碍的常规筛查和充分评估是必要的,以便有效应对其对癌症护理造成的多方面复杂后果。