Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
Psychooncology. 2021 Jul;30(7):1151-1159. doi: 10.1002/pon.5630. Epub 2021 Feb 2.
To derive and validate a risk scoring system for predicting major depressive disorder (MDD) and complicated grief (CG) among bereaved family members of patients with cancer that is feasible for clinical use.
We conducted a secondary analysis of two cross-sectional nationwide bereavement surveys in Japan. From a total of 17,312 bereaved family members of patients with cancer, 8618 and 8619 were randomly assigned to a derivation and a validation group. The Patient Health Questionnaire 9 (PHQ-9) and the Brief Grief Questionnaire (BGQ) were used to assess MDD (PHQ-9 score ≥ 10) and CG (BGQ score ≥ 8), respectively. We compared five models with potential predictive variables that could be easily obtained in daily practice and were included in the bereavement survey (i.e., sociodemographic data).
The model which included variables such as the families' physical/mental health status and preparedness toward bereavement, in addition to their sociodemographic data, was considered modest for predicting the risk of both MDD and CG. The areas around the curve for MDD and CG were 0.74 (95% CI: 0.73-0.76) and 0.74 (95% CI: 0.72-0.75) and 0.78 (95% CI: 0.76-0.79) and 0.77 (95% CI: 0.76-0.79) in the derivation and validation groups, respectively.
We developed a clinical risk score for predicting MDD and CG among bereaved family members of patients with cancer. However, further research is needed for external validation and assessment regarding its implementation in actual practice.
为癌症患者的丧亲家庭成员中预测重度抑郁症（MDD）和复杂性悲伤（CG）开发并验证一种可行的临床使用的风险评分系统。
我们对日本两项全国性丧亲调查的二次分析。从总共 17312 名癌症患者的丧亲家庭成员中，随机分配 8618 人和 8619 人到推导组和验证组。使用患者健康问卷 9 项（PHQ-9）和简要悲伤问卷（BGQ）分别评估 MDD（PHQ-9 得分≥10）和 CG（BGQ 得分≥8）。我们比较了五个模型，这些模型具有可在日常实践中轻松获得且包含在丧亲调查中的潜在预测变量（即社会人口统计学数据）。
考虑到家庭的身心健康状况和对丧亲的准备情况，除了社会人口统计学数据之外，还包括变量的模型被认为适度地预测了 MDD 和 CG 的风险。MDD 和 CG 的曲线下面积分别为 0.74（95%CI：0.73-0.76）和 0.74（95%CI：0.72-0.75），0.78（95%CI：0.76-0.79）和 0.77（95%CI：0.76-0.79）在推导组和验证组中。
我们为癌症患者的丧亲家庭成员中预测 MDD 和 CG 开发了一种临床风险评分。但是，还需要进一步的外部验证和实际应用评估。
