Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Psychooncology. 2021 Jun;30(6):962-969. doi: 10.1002/pon.5683. Epub 2021 Apr 8.
Distress and depression are prevalent in cancer patients throughout survivorship and are associated with adverse outcomes. This study examines the association between outpatient psycho-oncology treatment and distress and depression in cancer patients.
This is a prospective observational study of adult patients with a primary diagnosis of cancer referred for psycho-oncology services. Patients were seen for two psycho-oncology visits in a single clinical setting with various qualified providers. Patients completed the distress thermometer and problem checklist (DT + PL) and the Patient Health Questionnaire (PHQ-9) at the beginning of their first and second visits and repeated the DT at the end of these visits.
The analysis included 174 patients seen once and 69 patients seen twice. Patients were seen on average 2.5 years after diagnosis. Both visits were associated with significant reductions in distress (5.56 before and 3.85 after for visit 1, p < 0.001; 4.92 before and 3.43 after for visit 2, p < 0.001). There was a significant reduction in distress from baseline to after visit 2 (p < 0.001). Depression scores significantly decreased from the first to second visits (8.79-7.57; p = 0.002).
Psycho-oncology services were associated with significant reductions in distress and depression, with scores after services no longer meeting criteria for clinically significant distress (DT scores ≥ 4) and depression (PHQ-9 scores ≥ 8) as they did at baseline. Reductions in distress and depression were not significantly associated with provider type, intervention or timing of diagnosis. These findings support the use of psycho-oncology services in cancer patients throughout survivorship.
在癌症患者的整个生存期间，痛苦和抑郁普遍存在，并与不良结局相关。本研究探讨了门诊心理肿瘤学治疗与癌症患者痛苦和抑郁之间的关系。
这是一项针对接受心理肿瘤学服务的成年癌症患者的前瞻性观察研究。患者在单个临床环境中由各种合格的提供者进行两次心理肿瘤学就诊。患者在首次和第二次就诊的开始时完成了痛苦温度计和问题清单（DT+PL）和患者健康问卷（PHQ-9），并在这些就诊结束时重复了 DT。
分析包括 174 名仅就诊一次的患者和 69 名就诊两次的患者。患者在诊断后平均就诊 2.5 年。两次就诊均显著降低了痛苦（就诊 1 时从 5.56 降至 3.85，p<0.001；就诊 2 时从 4.92 降至 3.43，p<0.001）。从基线到就诊 2 后，痛苦显著降低（p<0.001）。抑郁评分从第一次就诊到第二次就诊显著下降（8.79-7.57；p=0.002）。
心理肿瘤学服务与痛苦和抑郁的显著降低相关，服务后的评分不再符合临床上显著痛苦（DT 评分≥4）和抑郁（PHQ-9 评分≥8）的标准，而在基线时则符合这些标准。痛苦和抑郁的减少与提供者类型、干预措施或诊断时间没有显著关联。这些发现支持在癌症患者的整个生存期间使用心理肿瘤学服务。
