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遗传检测如何影响焦虑、抑郁和生活质量?一项遗传性乳腺癌和卵巢癌综合征疑似患者试验。

How does genetic testing influence anxiety, depression, and quality of life? A hereditary breast and ovarian cancer syndrome suspects trial.

机构信息

Department of Psychology, Hospital Haroldo Juaçaba, the Ceará Cancer Institute, Fortaleza, Brazil.

Laboratory of Genetics and Molecular Biology, Hospital Haroldo Juaçaba, the Ceará Cancer Institute, Fortaleza, Brazil.

出版信息

Support Care Cancer. 2021 Jul;29(7):3521-3530. doi: 10.1007/s00520-020-05867-2. Epub 2020 Nov 5.

Abstract

BACKGROUND

Emotional distress associated with genetic testing for hereditary breast and ovarian cancer syndrome (HBOC) is reported to interfere with adherence to treatment and prophylactic measures and compromise quality of life.

OBJECTIVES

To determine levels of anxiety, depression, and quality of life in patients tested for pathogenic BRCA1/2 mutations and identify risk factors for the development of adverse psycho-emotional effects.

METHODS

Cross-sectional observational trial involving 178 breast or ovarian cancer patients from a referral cancer hospital in Northeastern Brazil. Information was collected with the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization (WHO) Quality of Life (QoL) questionnaire (WHOQOL-BREF).

RESULTS

Patients suspected of HBOC had higher levels of anxiety than depression. The presence of (probably) pathogenic BRCA1/2 mutations did not affect levels of anxiety and depression. High schooling, history of psychiatric disease, and use of psychotropic drugs were directly associated with high anxiety. High schooling was too inversely associated with QoL as such a breast tumor. Anxiety and depression were directly correlated and both reduced significantly QoL.

CONCLUSION

Our results highlight the importance of psychological support and screening of risk factors for anxiety and depression and low QoL in HBOC patients at the time of testing.

摘要

背景

遗传性乳腺癌和卵巢癌综合征 (HBOC) 的基因检测与情绪困扰相关,据报道,这种困扰会干扰治疗和预防措施的依从性,并影响生活质量。

目的

确定接受致病性 BRCA1/2 突变检测的患者的焦虑、抑郁水平,并确定发生不良心理情绪影响的风险因素。

方法

这是一项在巴西东北部一家癌症转诊医院进行的 178 例乳腺癌或卵巢癌患者的横断面观察性试验。使用医院焦虑和抑郁量表(HADS)和世界卫生组织(WHO)生活质量(QoL)问卷(WHOQOL-BREF)收集信息。

结果

疑似 HBOC 的患者焦虑水平高于抑郁水平。存在(可能)致病性 BRCA1/2 突变与焦虑和抑郁水平无关。高学历、精神病史和使用精神药物与高焦虑直接相关。高学历与 QoL 呈负相关,这种负相关与乳腺癌肿瘤相似。焦虑和抑郁呈直接相关,两者均显著降低 QoL。

结论

我们的研究结果强调了在进行检测时,对 HBOC 患者进行心理支持和焦虑、抑郁及 QoL 降低风险因素筛查的重要性。

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