Ju Hyun-Bin, Kang Eun-Chan, Jeon Dong-Wook, Kim Tae-Hyun, Moon Jung-Joon, Kim Sung-Jin, Choi Ji-Min, Jung Do-Un
Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Psychiatry Investig. 2018 Feb;15(2):133-140. doi: 10.30773/pi.2017.07.26. Epub 2017 Oct 30.
The objective of present study is to analyze the prevalence of depression and anxiety following breast cancer surgery and to assess the factors that affect postoperative psychological symptoms.
The Hamilton Rating Scale for Depression (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Body Image Scale (BIS), and Rosenberg Self Esteem Scale (RSES) were used to assess the psychological states of patients who had been diagnosed with and had undergone surgery for breast cancer. Blood concentrations of the stress markers adrenocorticotropic hormone, cortisol, arginine-vasopressin, and angiotensin-converting enzyme were measured. Pearson's correlation analysis and multilinear regression analysis were used to analyse the data.
At least mild depressive symptoms were noted in 50.5% of patients, while 42.4% of patients exhibited at least mild anxiety symptoms. HAM-D score was positively correlated with HAM-A (r=0.83, p<0.001) and BIS (r=0.29, p<0.001) scores and negatively correlated with RSES score (r=-0.41, p<0.001). HAM-A score was positively correlated with BIS score (r=0.32, p<0.001) and negatively correlated with RSES score (r=-0.27, p<0.001). There were no statistically significant associations between stress markers and depression/anxiety.
Patients with breast cancer frequently exhibit postoperative depression and anxiety, which are related to low levels of self-esteem and distorted body image.
本研究的目的是分析乳腺癌手术后抑郁和焦虑的患病率，并评估影响术后心理症状的因素。
采用汉密尔顿抑郁量表（HAM-D）、汉密尔顿焦虑量表（HAM-A）、身体意象量表（BIS）和罗森伯格自尊量表（RSES）对已诊断并接受乳腺癌手术的患者的心理状态进行评估。测量应激标志物促肾上腺皮质激素、皮质醇、精氨酸加压素和血管紧张素转换酶的血浓度。采用Pearson相关分析和多元线性回归分析对数据进行分析。
50.5%的患者至少有轻度抑郁症状，而42.4%的患者至少有轻度焦虑症状。HAM-D评分与HAM-A评分（r=0.83，p<0.001）和BIS评分（r=0.29，p<0.001）呈正相关，与RSES评分（r=-0.41，p<0.001）呈负相关。HAM-A评分与BIS评分（r=0.32，p<0.001）呈正相关，与RSES评分（r=-0.27，p<0.001）呈负相关。应激标志物与抑郁/焦虑之间无统计学意义的关联。
乳腺癌患者术后常出现抑郁和焦虑，这与自尊水平低和身体意象扭曲有关。
