Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
Liverpool Ocular Oncology Centre, Royal Liverpool and Broadgreen University Hospital, NHS Trust, Liverpool, UK.
Psychooncology. 2018 Jul;27(7):1727-1734. doi: 10.1002/pon.4715. Epub 2018 Apr 19.
We examined the role of posttreatment symptoms and functional problems and of worry about recurrent disease (WREC) in predicting probable anxiety and depression cases 24 months after diagnosis in survivors of posterior uveal melanoma. We examined whether WREC mediates links between symptoms, functional problems, and probable anxiety and depression cases.
Prospective cohort study of 261 treated uveal melanoma survivors 6, 12, and 24 months after diagnosis. Hierarchical logistic regression analyses predicting anxiety and depression 24 months after diagnosis identified by Hospital Anxiety and Depression Scale cutoff scores. Symptoms, functional problems, and WREC 6-month posttreatment were entered into the analyses as predictors, then the same variables at 12 months. We controlled anxiety or depression at 6 and 12 months and chromosome 3 status, which accurately predicts 10-year survival. Mediation of links between 6-month symptoms and functional problems and 24-month anxiety and depression by 12-month WREC was tested.
Anxiety caseness at 24 months was predicted by 6-month ocular irritation, headache, and functional problems and 12-month WREC. Depression caseness at 24 months was predicted by 6-month headache and functional problems. Worry about recurrent disease at 12 months mediated prediction of anxiety caseness by 6-month symptoms and functional problems. Chromosome 3 status predicted neither anxiety nor depression.
Survivors reporting symptoms, functional problems, and WREC should be monitored for anxiety and depression. Appropriate reassurance that symptoms do not signify future disease might help prevent anxiety.
我们研究了治疗后症状和功能问题以及对复发性疾病的担忧（WREC）在后葡萄膜黑色素瘤幸存者诊断后 24 个月预测可能的焦虑和抑郁病例中的作用。我们研究了 WREC 是否在症状、功能问题和可能的焦虑和抑郁病例之间的联系中起中介作用。
对 261 名接受治疗的后葡萄膜黑色素瘤幸存者进行前瞻性队列研究，在诊断后 6、12 和 24 个月进行随访。通过医院焦虑和抑郁量表的临界值分数预测 24 个月后诊断出的焦虑和抑郁病例，采用分层逻辑回归分析。将治疗后 6 个月的症状、功能问题和 WREC 作为预测因素纳入分析，然后将相同的变量纳入 12 个月的分析。我们控制了 6 个月和 12 个月的焦虑或抑郁以及染色体 3 状态，该状态准确预测了 10 年的生存率。测试了 6 个月症状和功能问题与 12 个月 WREC 之间与 24 个月焦虑和抑郁相关的联系的中介作用。
24 个月时的焦虑病例由 6 个月时的眼部刺激、头痛和功能问题以及 12 个月时的 WREC 预测。24 个月时的抑郁病例由 6 个月时的头痛和功能问题预测。12 个月时的 WREC 中介了 6 个月时的症状和功能问题对焦虑病例的预测。染色体 3 状态既不能预测焦虑也不能预测抑郁。
报告有症状、功能问题和 WREC 的幸存者应监测焦虑和抑郁。适当的安慰表明症状不预示未来的疾病，可能有助于预防焦虑。
