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与头颈部癌症自杀意念风险相关的因素:一项纵向研究。

Factors associated with suicidal ideation risk in head and neck cancer: A longitudinal study.

机构信息

Center for Institutional Affairs, National Taichung University of Education, Taichung, Taiwan.

Department of Otorhinolaryngology-Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan.

出版信息

Laryngoscope. 2019 Nov;129(11):2491-2495. doi: 10.1002/lary.27843. Epub 2019 Jan 28.

DOI:10.1002/lary.27843
PMID:30690748
Abstract

OBJECTIVES/HYPOTHESIS: The risk factors associated with suicidal ideation among patients with head and neck cancer (HNC) have rarely been investigated. Thus, this study proposed an effective screening model to facilitate the identification of patients with HNC who are at risk of committing suicide.

STUDY DESIGN

Retrospective longitudinal study.

METHODS

We recruited 286 inpatients with HNC who were referred to the psychiatry department for an emotional distress assessment during cancer treatment. Sociodemographic and clinical factors, as well as Distress Thermometer (DT) scoring, were gathered and analyzed using multivariate logistic regression.

RESULTS

Among the patients, 27 (9.4%) were recognized as having suicidal ideation. A logistic regression analysis revealed five significant indicators associated with suicidal ideation, namely depression (odds ratio [OR]: 42.83), dysphoria (OR: 8.06), hypopharyngeal cancer (OR: 4.61), cancer history (OR: 4.53), and average DT scores (OR: 1.84). Based on the receiver operating characteristic and logistic regression, the model can predict suicidal ideation with 93.4% accuracy (area under the curve value).

CONCLUSIONS

Our findings provide strong evidence that patients with depression, hypopharyngeal cancer, higher DT scores, and previous cancer history can be quickly screened for suicidal ideation, which may help to prevent suicide events in patients with HNC.

LEVEL OF EVIDENCE

3b Laryngoscope, 129:2491-2495, 2019.

摘要

目的/假设:头颈部癌症(HNC)患者自杀意念的相关风险因素很少被研究。因此,本研究提出了一种有效的筛选模型,以帮助识别有自杀风险的 HNC 患者。

研究设计

回顾性纵向研究。

方法

我们招募了 286 名因癌症治疗期间情绪困扰而被转介到精神科进行评估的 HNC 住院患者。收集并分析了人口统计学和临床因素以及痛苦温度计(DT)评分,使用多变量逻辑回归。

结果

在这些患者中,有 27 名(9.4%)被认为有自杀意念。逻辑回归分析显示,与自杀意念相关的五个显著指标分别为抑郁(优势比[OR]:42.83)、烦躁(OR:8.06)、下咽癌(OR:4.61)、癌症病史(OR:4.53)和平均 DT 评分(OR:1.84)。基于接收者操作特征和逻辑回归,该模型可以预测自杀意念,准确率为 93.4%(曲线下面积值)。

结论

我们的研究结果提供了有力的证据,表明患有抑郁症、下咽癌、更高的 DT 评分和既往癌症病史的患者可以快速筛查自杀意念,这可能有助于预防 HNC 患者的自杀事件。

证据水平

3b Laryngoscope,129:2491-2495,2019。

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