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前列腺癌根治术后患者焦虑和抑郁的患病率及相关因素的纵向评估。

Longitudinal Assessment of Prevalence and Risk Factors of Anxiety and Depression among Prostate Cancer Survivors Post-Resection.

机构信息

Department of Urology Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150010, China.

出版信息

Psychiatr Q. 2021 Sep;92(3):995-1009. doi: 10.1007/s11126-020-09869-5. Epub 2021 Jan 6.

Abstract

Our study aimed to detect the longitudinal prevalence of anxiety and depression in prostate cancer survivors post-resection and their risk factors. A total of 169 prostate cancer patients who underwent resection were included and followed up for 3 years. Then anxiety and depression were assessed by Zung's Self-rating Anxiety Scale (SAS) or Zung's Self-rating Depression Scale (SDS) from the day of discharging from hospital to the last follow up every 3 months. Overall survival (OS) was calculated and documented. In prostate cancer survivors post-resection, the SAS score, anxiety occurrence rate, SDS score and depression occurrence rate all gradually elevated from baseline to month 36. Multivariate logistic regression analysis disclosed that age ≥ 65 years, education duration<9 years, marry status of single/divorced/widowed, unemployment before surgery, diabetes, and hyperlipidemia, higher Gleason score, higher pathological T stage, higher pathological N stage, positive surgical margin status were independent factors related to higher anxiety risk in the 3 years follow-up duration. Additionally, unemployment before surgery, hyperlipidemia, higher pathological T stage, higher pathological N stage, positive surgical margin status were independently associated with depression risk in the 3 years follow-up duration. In addition, baseline anxiety, baseline depression, 1-year depression and 2-year depression associated with worse OS. In conclusion, post-resection anxiety and depression continuously worsen in prostate cancer survivors, and age, marriage status, education duration, complications, and tumor features can serve as their risk factors.

摘要

本研究旨在检测前列腺癌根治术后患者纵向焦虑和抑郁的发生率及其危险因素。共纳入 169 例接受根治性手术的前列腺癌患者,随访 3 年。然后,从出院当天到最后一次每 3 个月随访,采用zung 自评焦虑量表(SAS)或zung 自评抑郁量表(SDS)评估焦虑和抑郁。计算并记录总生存(OS)。在前列腺癌根治术后患者中,SAS 评分、焦虑发生率、SDS 评分和抑郁发生率均从基线逐渐升高至 36 个月。多因素 logistic 回归分析显示,年龄≥65 岁、教育年限<9 年、未婚/离婚/丧偶、术前失业、糖尿病和高脂血症、较高的 Gleason 评分、较高的病理 T 分期、较高的病理 N 分期、阳性手术切缘状态是与 3 年随访期间发生更高焦虑风险的独立因素。此外,术前失业、高脂血症、较高的病理 T 分期、较高的病理 N 分期、阳性手术切缘状态与 3 年随访期间的抑郁风险独立相关。此外,基线焦虑、基线抑郁、1 年抑郁和 2 年抑郁与较差的 OS 相关。总之,前列腺癌根治术后患者的焦虑和抑郁持续恶化,年龄、婚姻状况、教育年限、并发症和肿瘤特征可作为其危险因素。

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