Zhang Xinyao, Zhang Xiaoye
Department of the Fourth Medical Oncology, Sheng Jing Hospital, China Medical University, Shenyang 110004, China.
Zhongguo Fei Ai Za Zhi. 2017 Jul 20;20(7):473-478. doi: 10.3779/j.issn.1009-3419.2017.07.06.
Lung cancer is a serious threat to human health and its morbidity and mortality in recent years has always been ranked first in the country. Lung cancer patients are often associated with anxiety, depression and other emotional problems, and anxiety, depression and other emotional problems will further lead to a series of somatic symptoms. At present, we lack the clinical understanding of somatization symptoms in patients with lung cancer and related clinical studies are not too much. This research is to study the features of clinical manifestation of lung cancer patients with somatization symptoms and correlative analysis between anxiety, depression and somatization symptoms in medical oncology department of general hospital.
Lung cancer patients who met somatization symptoms diagnostic standard were assessed with the self-constructed somatic symptoms investigation questionnaire, the Chinese version of the Patient Health Questionnaire-15 (PHQ-15) and anxiety and depression were recorded by the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). The detection rate of the anxiety, depression and the number of patients with different severity somatization symptoms were calculated, the relationship between the PHQ-15 scores and anxiety and/or depression and the distribution of the different frequency somatization symptoms were analyzed.
There were 43 patients with anxiety and/or depression in the 50 lung cancer patients with somatization symptoms. Prevalence rates of anxiety, depression and anxiety combined with depression were 10%, 10% and 66% respectively. The more severity the somatization symptoms are, the higher detection rates of anxiety combined with depression are. Significant positive correlations were observed between PHQ-15 scores, PHQ-15 positive symptom numbers and HAMA scores (r=0.752, P<0.001; r=0.710, P<0.001), HAMD scores (r=0.648, P<0.001; r=0.618, P<0.001). The most common somatization symptoms were fatigue (96%), weakness (88%), sleep disturbance (84%), dizziness (82%), and pain in extremities (80%). There was no significant statistical difference in somatization symptoms between lung cancer patients with different gender (P>0.05).
CONCLUSIONS: Symptoms of anxiety or depression were very common in lung cancer patients with somatization symptoms and there was a close relationship between anxiety, depression, and somatization symptoms. The most common symptoms of these patients were nonspecific generalized symptoms. .
肺癌严重威胁人类健康,近年来其发病率和死亡率在我国一直位居首位。肺癌患者常伴有焦虑、抑郁等情绪问题,而焦虑、抑郁等情绪问题又会进一步导致一系列躯体症状。目前,我们对肺癌患者躯体化症状缺乏临床认识,相关临床研究也不多。本研究旨在探讨综合医院肿瘤内科肺癌伴躯体化症状患者的临床表现特点以及焦虑、抑郁与躯体化症状之间的相关性分析。
对符合躯体化症状诊断标准的肺癌患者采用自行编制的躯体症状调查问卷、中文版患者健康问卷-15(PHQ-15)进行评估,采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)记录焦虑和抑郁情况。计算焦虑、抑郁的检出率以及不同严重程度躯体化症状的患者人数,分析PHQ-15得分与焦虑和/或抑郁的关系以及不同频次躯体化症状的分布情况。
50例有躯体化症状的肺癌患者中,有43例伴有焦虑和/或抑郁。焦虑、抑郁以及焦虑合并抑郁的患病率分别为10%、10%和66%。躯体化症状越严重,焦虑合并抑郁的检出率越高。PHQ-15得分、PHQ-15阳性症状数与HAMA得分(r=0.752,P<0.001;r=0.710,P<0.001)、HAMD得分(r=0.648,P<0.001;r=0.618,P<0.001)之间均存在显著正相关。最常见的躯体化症状为疲劳(96%)、虚弱(88%)、睡眠障碍(84%)、头晕(82%)和四肢疼痛(80%)。不同性别肺癌患者的躯体化症状差异无统计学意义(P>0.05)。
伴有躯体化症状的肺癌患者中焦虑或抑郁症状非常常见,且焦虑、抑郁与躯体化症状之间关系密切。这些患者最常见的症状为非特异性全身症状。