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区分抑郁症状与类似癌症相关的躯体症状:对乳腺癌后重度抑郁症评估和管理的启示

Distinguishing Depressive Symptoms From Similar Cancer-Related Somatic Symptoms: Implications for Assessment and Management of Major Depression after Breast Cancer.

作者信息

Thompson Lora M A, Bobonis Babilonia Margarita

机构信息

From the Supportive Care Medicine Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.

出版信息

South Med J. 2017 Oct;110(10):667-672. doi: 10.14423/SMJ.0000000000000705.

Abstract

Prevalence rates of major depressive disorder (MDD) following breast cancer diagnosis are estimated to be ~5% to >20%, and these rates range from slightly below to somewhat above the expected prevalence rate for MDD in the general population of women in the United States. Women with a history of MDD are at increased risk for recurrence of MDD after breast cancer and need to be monitored closely. To properly diagnose and treat MDD, healthcare providers must be able to recognize depressive symptoms and distinguish them from similar somatic symptoms that are associated with breast cancer and breast cancer treatment. The National Comprehensive Cancer Network and the American Society of Clinical Oncology have published guidelines for the screening, assessment, and care of adult cancer patients with depressive symptoms. Use of a standardized and validated screening measure may help healthcare providers identify patients in need of further assessment or treatment. Evidence-based nonpharmacological interventions such as cognitive behavioral therapy and antidepressant medications are recommended treatment options.

摘要

乳腺癌诊断后,重度抑郁症(MDD)的患病率估计为5%至超过20%,这些患病率略低于或略高于美国女性普通人群中MDD的预期患病率。有MDD病史的女性在患乳腺癌后MDD复发的风险增加,需要密切监测。为了正确诊断和治疗MDD,医疗保健提供者必须能够识别抑郁症状,并将其与与乳腺癌和乳腺癌治疗相关的类似躯体症状区分开来。美国国立综合癌症网络和美国临床肿瘤学会已经发布了针对有抑郁症状的成年癌症患者的筛查、评估和护理指南。使用标准化和经过验证的筛查措施可能有助于医疗保健提供者识别需要进一步评估或治疗的患者。推荐的治疗选择包括基于证据的非药物干预措施,如认知行为疗法和抗抑郁药物。

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