Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of psychological medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Curr Probl Cancer. 2020 Oct;44(5):100558. doi: 10.1016/j.currproblcancer.2020.100558. Epub 2020 Feb 10.
It has been reported that younger breast cancer patients are at greater risk of having psychological problems than their older counterparts. This study is conducted to evaluate the psychological status of Chinese postoperative breast cancer patients aged 35 years or younger and understand the associated factors in this patient group.
This cross-sectional study prospectively enrolled 114 Chinese postoperative breast cancer patients aged 35 years or younger. They completed standard instruments evaluating depression (Patient Health Questionnaire [PHQ]-9) and anxiety (General Anxiety Disorder-7). Logistic regression was used to identify the associated factors.
The mean scores were 5.21 and 4.19 for the PHQ-9 and General Anxiety Disorder-7, respectively. There were 76.3%, 20.2%, and 3.5% patients categorized into the none and/or mild (score 1-7), moderate (score 8-14), and moderate to severe depression (score 15-19) groups, respectively. For anxiety, there were 91.2%, 5.3% and, 3.5% of patients in the none and/or mild anxiety (score 0-9), moderate anxiety (score 10-14), and severe anxiety (score 15-21) groups, respectively. With univariate analysis, cohabitation status (P = 0.002) and adjuvant endocrine therapy (P = 0.048) tended to be associated with the level of depression (PHQ-9 ≥ 8). In the multivariate analysis, living alone (odds ratio = 5.08, 95% confidence interval = 1.81-14.26, P = 0.002) and the administration of ovarian function suppression (odds ratio = 2.76, 95% confidence interval = 1.04-7.37, P = 0.042) were still independently correlated with a higher level of depression. No significant predictors were found for anxiety.
Our study evaluated the depression and anxiety of young Chinese breast cancer patients; addressing the psychosocial assessment of these patients should be integrated into cancer treatments and follow-ups, especially for those receiving ovarian function suppression and living alone.
已有研究报道，相较于年长的乳腺癌患者，年轻乳腺癌患者发生心理问题的风险更高。本研究旨在评估中国≤35 岁乳腺癌术后患者的心理状况，并了解该患者群体的相关影响因素。
本横断面研究前瞻性纳入 114 例中国≤35 岁乳腺癌术后患者。患者完成了评估抑郁（患者健康问卷[PHQ]-9）和焦虑（广泛性焦虑障碍量表-7）的标准量表。采用 Logistic 回归分析确定相关因素。
PHQ-9 和广泛性焦虑障碍量表-7 的平均得分为 5.21 分和 4.19 分。分别有 76.3%、20.2%和 3.5%的患者被归类为无/轻度抑郁（得分 1-7）、中重度抑郁（得分 8-14）和中重度至重度抑郁（得分 15-19）组。对于焦虑，分别有 91.2%、5.3%和 3.5%的患者被归类为无/轻度焦虑（得分 0-9）、中度焦虑（得分 10-14）和重度焦虑（得分 15-21）组。单因素分析显示，婚姻状况（P=0.002）和辅助内分泌治疗（P=0.048）与抑郁程度（PHQ-9≥8）有关。多因素分析显示，独居（比值比[OR] = 5.08，95%置信区间[CI] = 1.81-14.26，P=0.002）和卵巢功能抑制的应用（OR = 2.76，95%CI = 1.04-7.37，P=0.042）与更高水平的抑郁仍独立相关。未发现焦虑的显著预测因素。
本研究评估了年轻中国乳腺癌患者的抑郁和焦虑情况；应对这些患者的社会心理评估应纳入癌症治疗和随访中，尤其是对于接受卵巢功能抑制和独居的患者。
