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青少年和青年癌症患者的自杀意念和抑郁。

Suicidal Ideation and Depression Among Adolescent and Young Adult Cancer Patients.

机构信息

Behavioral Sciences, UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA.

Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA.

出版信息

J Adolesc Young Adult Oncol. 2021 Oct;10(5):549-554. doi: 10.1089/jayao.2020.0180. Epub 2021 Apr 15.

Abstract

Adolescent and young adult (AYA) cancer patients (aged 18-39 years) represent a unique population within oncology. The developmental and mental health challenges that can co-occur with a diagnosis of cancer during this age range make AYAs a high-risk group for mental health problems, including depression and suicidal ideation. Therefore, the objective of this study was to assess the differences in rates of suicidal ideation and depression between AYAs and older adults (OAs; aged 40+ years) within an outpatient cancer support clinic. Depression screening data from routine clinical care were gathered and analyzed for adult patients receiving support services at an outpatient academic cancer clinic. The general mental health screening protocol included the Patient Health Questionnaire (PHQ)-9, which was used as a measure of depression symptoms, including suicidal ideation. Five hundred cancer survivors were included in the initial data analysis, with 21 (40.38%) of the AYAs and 143 (31.92%) of the OAs scoring ≥5 on the PHQ-9. Statistical analysis of groups at this cutoff score reflected no significant difference in depression between AYA and OA groups. However, a chi-square analysis revealed significantly higher suicidal ideation endorsement by AYAs versus OAs in this sample (χ [1,  = 500] = 3.98,  = 0.046). Results from routinely collected clinical data reveal a higher rate of suicidal ideation in AYAs compared with OA cancer patients, which supports the need for additional research on AYA cancer patient suicidal ideation in different settings and the implementation of mental health programs specifically for AYA patients.

摘要

青少年和年轻成人(AYA)癌症患者(年龄 18-39 岁)是肿瘤学中的一个独特群体。在这个年龄段,癌症诊断可能同时伴随着发育和心理健康挑战,这使得 AYA 成为心理健康问题(包括抑郁和自杀意念)的高风险群体。因此,本研究的目的是评估在一个门诊癌症支持诊所中,AYA 与老年患者(40 岁以上)之间自杀意念和抑郁的发生率差异。 从常规临床护理中收集并分析了接受门诊学术癌症诊所支持服务的成年患者的抑郁筛查数据。一般心理健康筛查方案包括患者健康问卷(PHQ-9),用于评估抑郁症状,包括自杀意念。 初步数据分析共纳入 500 名癌症幸存者,其中 21 名(40.38%)AYA 和 143 名(31.92%)OAs 的 PHQ-9 得分为≥5。在这个截点分数的组间统计分析反映了 AYA 和 OA 组之间的抑郁无显著差异。然而,卡方分析显示,在这个样本中,AYA 比 OA 更倾向于表达自杀意念(χ[1, n=500]=3.98, p=0.046)。 常规收集的临床数据结果显示,与老年癌症患者相比,AYA 中自杀意念的发生率更高,这支持在不同环境下对 AYA 癌症患者自杀意念进行更多研究的必要性,以及为 AYA 患者实施专门的心理健康计划。

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