Department of Neurosurgery, The First Hospital of China Medical University, No. 155, Nanjingbei Street, Heping, Shenyang, 110001, Liaoning, People's Republic of China.
Department of Emergency Medicine, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng, Beijing, 100053, People's Republic of China.
Support Care Cancer. 2019 Jan;27(1):257-263. doi: 10.1007/s00520-018-4321-z. Epub 2018 Jun 25.
It is common for central nervous system (CNS) tumor patients to suffer from depressive symptoms. If unrecognized or untreated, CNS tumors may lead to many serious problems in these patients. This study examines the association of social support with depressive symptoms in CNS tumor patients and explores the extent to which hope mediates this relationship.
A total of 269 CNS tumor patients in China were included in this study. We assessed depressive symptoms using the Epidemiologic Studies Depression Scale (CES-D), social support using the Perceived Social Support Scale (PSSS), and hope using the Herth Hope Index (HHI). Questionnaires were distributed to collect these data. Hierarchical linear regression analyses explored the interrelationship between social support, hope, and depressive symptoms.
After adjustment for demographic characteristics, patients with less social support exhibited more depressive symptoms (β = - 0.452, P < 0.01). Social support explained 19.1% of the variance in depressive symptoms. After adding hope to the regression model, the effect size for social support was reduced by over half but remained significant (from β = - 0.452 to β = - 0.218, P < 0.01). In addition, a lower level of hope (β = - 0.386, P < 0.01) was associated with more depressive symptoms, and this measure explained an additional 9.3% of the variance in depressive symptoms.
Much of the relationship between social support and depressive symptoms is explained by hope. Thus, interventions boosting both social support and hope help to reduce depressive symptoms in patients with CNS tumors.
中枢神经系统（CNS）肿瘤患者常伴有抑郁症状。如果未被识别或未得到治疗，CNS 肿瘤可能会导致这些患者出现许多严重问题。本研究旨在探讨社会支持与 CNS 肿瘤患者抑郁症状之间的关系，并探讨希望在其中的中介作用。
本研究共纳入中国 269 名 CNS 肿瘤患者。采用流行病学研究抑郁量表（CES-D）评估抑郁症状，采用领悟社会支持量表（PSSS）评估社会支持，采用 Herth 希望量表（HHI）评估希望。通过问卷调查收集数据。采用分层线性回归分析探讨社会支持、希望与抑郁症状之间的相互关系。
调整人口统计学特征后，社会支持较少的患者抑郁症状更明显（β=-0.452，P<0.01）。社会支持解释了抑郁症状变异的 19.1%。在回归模型中加入希望后，社会支持的效应大小减小了一半以上，但仍具有统计学意义（β从-0.452 变为-0.218，P<0.01）。此外，较低的希望水平（β=-0.386，P<0.01）与更多的抑郁症状相关，该指标进一步解释了抑郁症状变异的 9.3%。
社会支持与抑郁症状之间的关系在很大程度上可以用希望来解释。因此，增强社会支持和希望的干预措施有助于减轻 CNS 肿瘤患者的抑郁症状。
