Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.
Psychosomatics. 2018 May-Jun;59(3):251-258. doi: 10.1016/j.psym.2018.01.007. Epub 2018 Jan 31.
Young adults with cancer experience disruptions in their normal developmental trajectories and commonly experience psychologic distress related to their diagnoses. Young women with metastatic breast cancer (MBC) are at particular risk of adverse mental health outcomes.
We sought to determine the prevalence of and factors associated with anxiety and depression symptoms in young women with newly diagnosed de novo MBC.
A total of 54 women with newly diagnosed de novo MBC were identified from an ongoing, prospective, multicenter cohort of women diagnosed with breast cancer at age <40. Depression and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Items assessing socio-demographics, physical symptom burden, social support, and disease and treatment history, with complementary medical record review, were used to assess variables potentially associated with anxiety and depression symptoms.
Mean HADS Depression score was 4.4 (standard deviation = 3.7) and mean HADS Anxiety score was 7.9 (standard deviation = 5.0). Eleven (20%) women scored ≥8 on the HADS Depression subscale, the suggested threshold for depression/anxiety screening, and 24 (44%) women scored ≥8 on the HADS Anxiety subscale. In a multivariable model of anxiety, higher physical symptom scores (odds ratio = 4.41, p = 0.005) was significantly associated with higher anxiety scores. None of the other variables improved the model fit.
In this study, a considerable proportion of young women with newly diagnosed MBC experienced anxiety symptoms, although depression was less common. Future strategies focused on distress reduction in young MBC patients should focus on physical symptom management as well as anxiety identification and management.
患有癌症的年轻人会经历正常发育轨迹的中断，并且通常会因诊断而感到心理困扰。患有转移性乳腺癌（MBC）的年轻女性特别容易出现不良心理健康后果。
我们旨在确定新诊断为初发 MBC 的年轻女性中焦虑和抑郁症状的患病率及其相关因素。
从正在进行的、前瞻性的、多中心乳腺癌患者队列中确定了 54 名新诊断为初发 MBC 的女性。使用医院焦虑和抑郁量表（HADS）评估抑郁和焦虑症状。使用评估社会人口统计学、身体症状负担、社会支持以及疾病和治疗史的项目（辅以补充病历审查）来评估与焦虑和抑郁症状相关的潜在变量。
平均 HADS 抑郁得分为 4.4（标准差=3.7），平均 HADS 焦虑得分为 7.9（标准差=5.0）。11 名（20%）女性 HADS 抑郁分量表得分为≥8，提示需要进行抑郁/焦虑筛查，24 名（44%）女性 HADS 焦虑分量表得分为≥8。在焦虑的多变量模型中，较高的身体症状评分（优势比=4.41，p=0.005）与较高的焦虑评分显著相关。其他变量均未改善模型拟合。
在这项研究中，相当一部分新诊断为 MBC 的年轻女性出现了焦虑症状，尽管抑郁症状较少见。未来针对年轻 MBC 患者的减轻痛苦的策略应侧重于身体症状管理以及焦虑的识别和管理。
