Brochmann Nana, Flachs Esben Meulengracht, Christensen Anne Illemann, Bak Marie, Andersen Christen Lykkegaard, Juel Knud, Hasselbalch Hans Carl, Zwisler Ann-Dorthe, Rottmann Nina
Department of Hematology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark,
Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
Clin Epidemiol. 2018 Dec 18;11:23-33. doi: 10.2147/CLEP.S162688. eCollection 2019.
We sought to determine the prevalence and severity of anxiety and depression among patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) and respective associations of anxiety and depression with demographic and lifestyle factors, comorbidity burden, duration of MPN disease, financial difficulties, and health-related quality of life (QoL).
This study used data from a nationwide, population-based, cross-sectional survey of health-related QoL in MPN patients in Denmark called the MPNhealthSurvey. Individuals with a diagnosis of MPN in the National Patient Register were invited. The Hospital Anxiety and Depression Scale was used to assess the prevalence and severity of anxiety and depression. The associations of anxiety and depression with age, sex, education, body mass index (BMI), smoking, alcohol intake, physical activity, comorbidity burden, duration of MPN disease, financial difficulties, symptom burden, sexual problems, fatigue, functioning, and global health/QoL were examined.
In total, 2,029 patients completed the Hospital Anxiety and Depression Scale. The prevalence of anxiety, depression, and both was 21%, 12%, and 8%, respectively. Many participants who reported anxiety or depression exhibited mild symptoms. Middle-aged and elderly participants had lower odds of experiencing anxiety and depression when compared to younger participants, and females had higher odds of anxiety compared to males. Participants with higher education had lower odds of anxiety compared to those with lower education. Current smokers and ex-smokers had higher odds of anxiety and depression compared to those who had never smoked, and sedentary participants and participants with a lower level of physical activity had higher odds of anxiety and depression compared to participants who performed hard training several times a week. Higher comorbidity burden increased the odds of depression, and greater financial difficulties increased the odds of anxiety and depression. Higher total symptom burden and fatigue burden and higher level of sexual problems increased the odds of anxiety and depression. Finally, lower functional level and global health/quality of life increased the odds of anxiety and depression. BMI, alcohol intake, comorbidity burden, and duration of disease were not substantially associated with anxiety, whereas sex, educational level, and duration of MPN disease were not substantially associated with depression.
There may be an unmet need in handling psychological distress in MPN patients. Future research might explore the utility of screening for psychological distress and the effectiveness of lifestyle interventions, rehabilitation, and MPN-symptom reduction in preventing and treating psychological distress.
我们旨在确定费城染色体阴性骨髓增殖性肿瘤(MPN)患者中焦虑和抑郁的患病率及严重程度,以及焦虑和抑郁与人口统计学和生活方式因素、合并症负担、MPN病程、经济困难和健康相关生活质量(QoL)之间的各自关联。
本研究使用了丹麦一项名为MPN健康调查的全国性、基于人群的MPN患者健康相关QoL横断面调查数据。邀请了在国家患者登记册中诊断为MPN的个体。使用医院焦虑抑郁量表评估焦虑和抑郁的患病率及严重程度。研究了焦虑和抑郁与年龄、性别、教育程度、体重指数(BMI)、吸烟、饮酒、身体活动、合并症负担、MPN病程、经济困难、症状负担、性问题、疲劳、功能以及总体健康/QoL之间的关联。
共有2029名患者完成了医院焦虑抑郁量表的测评。焦虑、抑郁以及两者共病的患病率分别为21%、12%和8%。许多报告有焦虑或抑郁症状的参与者表现为轻度症状。与年轻参与者相比中年和老年参与者出现焦虑和抑郁的几率较低,女性出现焦虑的几率高于男性。与低学历者相比高学历参与者出现焦虑的几率较低。与从不吸烟的人相比,目前吸烟者和既往吸烟者出现焦虑和抑郁的几率较高,与每周进行多次高强度训练的参与者相比,久坐不动和身体活动水平较低的参与者出现焦虑和抑郁的几率较高。更高的合并症负担增加了抑郁的几率,更大的经济困难增加了焦虑和抑郁的几率。更高的总症状负担和疲劳负担以及更高水平的性问题增加了焦虑和抑郁出现的几率。最后,更低的功能水平和总体健康/生活质量增加了焦虑和抑郁出现的几率。BMI、饮酒、合并症负担和病程与焦虑没有显著关联,而性别、教育程度和MPN病程与抑郁没有显著关联。
在处理MPN患者的心理困扰方面可能存在未满足的需求。未来的研究可以探索筛查心理困扰和生活方式干预、康复以及减轻MPN症状在预防和治疗心理困扰方面的效用和有效性。