Department of Medical Psychology and Medical Sociology.
Oncology Clinic, Rigshospitalet, University of Copenhagen.
Health Psychol. 2019 Mar;38(3):187-195. doi: 10.1037/hea0000713.
An increasing number of hematologic cancer patients outlive 10 years past diagnosis. Nevertheless, few studies investigated psychological strain in this patient group beyond 5 years after diagnosis. We conducted a registry-based investigation of risk for depression and anxiety among long-term hematologic cancer survivors up to 26 years after diagnosis compared to the general population.
In this cross-sectional postal survey, cancer survivors were recruited through 2 regional cancer registries in Germany. Depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) were assessed. Survivor data were compared to age- and gender-matched comparison groups (CG) randomly drawn from large representative samples (N > 5,000).
Out of 2,001 eligible patients, 46% participated (n = 922). Survivors were significantly more likely than the CG to report elevated depressive (relative risk [RR] = 3.1; 95% confidence interval [CI]: 2.2-4.3) and anxious symptomatology (RR = 1.7; 95% CI: 1.2-2.3). Depression scores remained high even in the survivor Group 12-26 years after diagnosis. RR for anxiety decreased to values comparable to the CG. Younger and middle-aged survivors (≤65 years) were at highest relative and absolute risk to be psychologically impaired.
This study shows that depression rather than anxiety is a prominent problem in long-term survivors of hematologic cancer. The results stress the importance of monitoring patients even years after diagnosing and supplying psychosocial support to patients in need. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
越来越多的血液系统癌症患者在确诊后能存活 10 年以上。然而，很少有研究调查诊断后 5 年以上血液系统癌症患者的心理压力。我们对诊断后 26 年内的长期血液系统癌症幸存者与普通人群进行了基于登记的抑郁和焦虑风险调查。
在这项横断面邮寄调查中，癌症幸存者通过德国的两个区域癌症登记处招募。使用患者健康问卷-9（PHQ-9）和广泛性焦虑障碍-7（GAD-7）评估抑郁和焦虑。将幸存者的数据与年龄和性别匹配的对照组（CG）进行比较，对照组是从大型代表性样本（>5000 人）中随机抽取的。
在 2001 名合格患者中，有 46%（n=922）参与了研究。与 CG 相比，幸存者报告出现升高的抑郁（相对风险 [RR] = 3.1；95%置信区间 [CI]：2.2-4.3）和焦虑症状（RR = 1.7；95% CI：1.2-2.3）的可能性显著更高。即使在诊断后 12-26 年内，幸存者组的抑郁评分仍保持较高水平。焦虑的 RR 降低到与 CG 相当的值。年轻和中年幸存者（≤65 岁）处于相对和绝对较高的心理受损风险中。
这项研究表明，在血液系统癌症的长期幸存者中，抑郁而不是焦虑是一个突出的问题。研究结果强调了即使在诊断多年后仍对患者进行监测以及为有需要的患者提供心理支持的重要性。
