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原发性脑肿瘤患者生活质量的精神和认知相关因素

Psychiatric and cognitive correlates of quality of life among persons with primary brain tumors.

作者信息

Srivastava Shruti, Bhatia Manjeet S, Gaur Aman, Singh Gurubachan

机构信息

Department of Psychiatry, Guru Tegh Bahadur Hospital, University College of Medical Sciences, Dilshad Garden, New Delhi, India.

Department of Neurosurgery, Guru Teg Bahadur Hospital, New Delhi, India.

出版信息

Ind Psychiatry J. 2019 Jan-Jun;28(1):141-147. doi: 10.4103/ipj.ipj_72_19. Epub 2019 Dec 11.

Abstract

BACKGROUND

Quality of life (QoL) in primary brain tumour (PBT) is often the main outcome measure in an otherwise incurable disease. The impact of psychiatric, cognitive correlates on quality of life in primary brain tumours is less well studied.

AIMS AND OBJECTIVES

The primary objective was to find out the association of psychiatric morbidity, cognitive functions with quality of life in patients with primary brain tumours. The secondary objective was to study whether any association exists with tumour grading, laterality, location and psychiatric morbidity.

MATERIALS AND METHODS

100 consecutive patients of PBT were screened in the Neuro-behavioural Clinic. Age, gender matched 52 healthy subjects were taken for comparison. Quality of life (qol) measure (EORTC), Hospital Anxiety Depression Scale (HADS), GHQ (12 item) and Mini Mental State Examination (MMSE) were administered.

RESULTS

52 PBT cases were included, out of which 17.30% had Organic Anxiety Disorder (F06.4), 23.07% had Organic Mood disorder (F06.3%).Statistically significant association was found in EORTC qol scores and anxiety scores (p 0.001), depressive scores (p 0.029), psychiatric morbidity (p0.000) .Significant association with tumour laterality, depression scores (p0.041) was found. PBT patients had poor quality of life as compared to matched healthy volunteers (p <0.001). Significant negative correlation between EORTC B-20, cognitive scores using Spearman's Rho (p0.005; r - 0.385), implying more symptoms with poor cognitive function scores. Psychiatric morbidity, cognitive dysfunction, poor qol were noted, though no association with tumour grading, location.

CONCLUSION

Regular assessments, early intervention will help in improving quality of life in PBT.

摘要

背景

在原发性脑肿瘤(PBT)中,生活质量(QoL)通常是这种无法治愈疾病的主要结局指标。精神和认知因素对原发性脑肿瘤患者生活质量的影响研究较少。

目的

主要目的是找出原发性脑肿瘤患者的精神疾病发病率、认知功能与生活质量之间的关联。次要目的是研究肿瘤分级、侧别、位置与精神疾病发病率之间是否存在关联。

材料与方法

在神经行为诊所对100例连续的原发性脑肿瘤患者进行筛查。选取年龄、性别匹配的52名健康受试者作为对照。采用生活质量(qol)量表(欧洲癌症研究与治疗组织)、医院焦虑抑郁量表(HADS)、一般健康问卷(12项)和简易精神状态检查表(MMSE)进行评估。

结果

纳入52例原发性脑肿瘤病例,其中17.30%患有器质性焦虑障碍(F06.4),23.07%患有器质性心境障碍(F06.3%)。在欧洲癌症研究与治疗组织生活质量评分与焦虑评分(p = 0.001)、抑郁评分(p = 0.029)、精神疾病发病率(p = 0.000)之间发现有统计学意义的关联。发现与肿瘤侧别、抑郁评分存在显著关联(p = 0.041)。与匹配的健康志愿者相比,原发性脑肿瘤患者的生活质量较差(p < 0.001)。使用Spearman秩相关分析,欧洲癌症研究与治疗组织B - 20评分与认知评分之间存在显著负相关(p = 0.005;r = - 0.385),这意味着认知功能评分较差时症状更多。观察到精神疾病发病率、认知功能障碍、生活质量较差,尽管与肿瘤分级、位置无关联。

结论

定期评估、早期干预将有助于改善原发性脑肿瘤患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/237a/6929219/97651333aa51/IPJ-28-141-g001.jpg

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