Department of Medicine I, Division of Palliative Medicine, Medical University of Vienna, Vienna, Austria.
Faculty of Psychology, University of Vienna, Vienna, Austria.
Psychooncology. 2021 Apr;30(4):504-510. doi: 10.1002/pon.5595. Epub 2020 Dec 3.
Pain depicts a severe physical symptom but its relationship to mental health problems is not well studied in cancer patients. The aim of this study was to investigate the prevalence of pain and its correlation with symptoms of post-traumatic stress disorder (PTSD), depression, anxiety and psychological distress in a large sample of cancer patients.
From 2010 to 2019, cancer patients who received outpatient treatment at the Medical University of Vienna were assessed with the Post-Traumatic Symptom Scale (PTSS-10) and the Hospital Anxiety and Depression Scales. A visual analogue scale was used to assess pain perception. For statistical analysis, linear regression models were applied to log-transformed data.
Of the 846 cancer patients included in the study, 63.5% experienced pain (mild 43.5%, moderate 13.6%, severe 6.4%). About a third (31.2%) of the total sample presented with significant PTSD symptoms. Significant symptoms of depression, anxiety and distress were present in 13.9%, 15.1% and 25.3%, respectively. Women more often reported symptoms of PTSD, anxiety and distress. Pain scores were significantly related to symptoms of PTSD, depression and psychological distress (all with p < .001), but not to anxiety.
Results show a high prevalence of experienced pain and indicate a clear association of elevated pain levels with psychiatric symptoms in oncological patients in a large Austrian sample. In order to decrease experienced pain and to enable better treatment of mental health problems in cancer patients, diagnostic procedures and interventions based on a biopsychosocial model need to be intensified.
疼痛描述了一种严重的身体症状,但它与癌症患者心理健康问题的关系尚未得到充分研究。本研究旨在调查大量癌症患者中疼痛的患病率及其与创伤后应激障碍(PTSD)、抑郁、焦虑和心理困扰症状的相关性。
2010 年至 2019 年,在维也纳医科大学接受门诊治疗的癌症患者接受了创伤后症状量表(PTSS-10)和医院焦虑抑郁量表评估。使用视觉模拟量表评估疼痛感知。为了进行统计分析,线性回归模型应用于对数转换后的数据。
在纳入研究的 846 名癌症患者中,63.5%经历了疼痛(轻度 43.5%,中度 13.6%,重度 6.4%)。大约三分之一(31.2%)的总样本存在明显的 PTSD 症状。抑郁、焦虑和困扰的显著症状分别为 13.9%、15.1%和 25.3%。女性更常报告 PTSD、焦虑和困扰症状。疼痛评分与 PTSD、抑郁和心理困扰症状显著相关(均 p <.001),但与焦虑无关。
结果显示疼痛的患病率较高,并表明在奥地利大样本中,升高的疼痛水平与肿瘤患者的精神症状明显相关。为了降低疼痛体验并使癌症患者的心理健康问题得到更好的治疗,需要加强基于生物-心理-社会模型的诊断程序和干预措施。