Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea; Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
Gen Hosp Psychiatry. 2018 Jan-Feb;50:33-37. doi: 10.1016/j.genhosppsych.2017.09.009. Epub 2017 Sep 29.
Although breast cancer patients' depression changes over time, most longitudinal studies have assessed the influence of only baseline depression on quality of life (QoL). Therefore, this study investigated the influence of changes in depression status on QoL in the year after surgery.
Participants were interviewed at 2-5days and at 1year after surgery. Depression was diagnosed at both time points, and participants were classified into four groups: no, recovered, incident, and persistent depression. QoL-related functioning and symptoms were evaluated with the EORTC QLQ-C30 questionnaire and the interaction of depression and QoL was analyzed using a repeated-measures analysis of covariance (RMANCOVA).
Of the 306 participants, 247 were evaluated at 1year after surgery; 165 had no depression, 40 had recovered from depression, 24 had incident depression, and 18 had persistent depression. The RMANCOVA revealed significant time-by-group interactions; the no-depression group exhibited better recovery in general QoL and functioning, whereas the persistent-depression group showed the worst recovery. QoL and functioning improved in the recovered depression group, but worsened in the group with incident depression.
The different impacts of changes in depression status on QoL highlight the importance of periodic screening for depression.
尽管乳腺癌患者的抑郁状态随时间而变化，但大多数纵向研究仅评估了基线抑郁对生活质量（QoL）的影响。因此，本研究调查了术后一年内抑郁状态变化对 QoL 的影响。
参与者在手术后 2-5 天和 1 年时接受访谈。在两个时间点均诊断为抑郁，并将参与者分为四组：无、已恢复、新发和持续抑郁。使用 EORTC QLQ-C30 问卷评估与 QoL 相关的功能和症状，并使用重复测量协方差分析（RMANCOVA）分析抑郁与 QoL 的相互作用。
在 306 名参与者中，247 名在手术后 1 年时接受了评估；165 名无抑郁，40 名已从抑郁中恢复，24 名新发抑郁，18 名持续抑郁。RMANCOVA 显示时间与组之间存在显著的交互作用；无抑郁组的一般 QoL 和功能恢复较好，而持续抑郁组的恢复最差。已恢复抑郁组的 QoL 和功能得到改善，但新发抑郁组的 QoL 和功能恶化。
抑郁状态变化对 QoL 的不同影响突出了定期筛查抑郁的重要性。
