Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Gynaecologic Oncology, Centre of Gynaecologic Oncology Amsterdam, Amsterdam, The Netherlands.
BJOG. 2022 Feb;129(3):444-449. doi: 10.1111/1471-0528.16849. Epub 2021 Aug 10.
To evaluate the short-term psychological consequences of gestational trophoblastic disease (GTD).
A prospective observational multicentre cohort study.
Nationwide in the Netherlands.
GTD patients.
Online questionnaires directly after diagnosis.
Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Impact of Event Scale (IES) and Reproductive Concerns Scale (RCS).
Sixty GTD patients were included between 2017 and 2020. Anxious feelings (47%) were more commonly expressed than depressive feelings (27%). Patients experienced moderate to severe adaptation problems in 88%. Patients who already had children were less concerned about their reproductivity than were patients without children (mean score 10.4 versus 15.0, P = 0.031), and patients with children experienced lower distress levels (IES mean score 25.7 versus 34.7, P = 0.020). In addition, patients with previous pregnancy loss scored lower for distress compared with patients without pregnancy loss (IES mean score 21.1 versus 34.2, P = 0.002).
We recommend that physicians monitor physical complaints and the course of psychological wellbeing over time in order to provide personalised supportive care in time for patients who have high levels of distress at baseline.
GTD patients experience increased levels of distress, anxiety and depression, suggesting the diagnosis has a substantial effect on the psychological wellbeing of patients. The impact of GTD diagnosis on intrusion and avoidance seems to be ameliorated in patients who have children or who have experienced previous pregnancy loss.
Patients with gestational trophoblastic disease (GTD) experience short-term psychological consequences such as distress, anxiety and depression, suggesting that the diagnosis GTD has a substantial effect on the psychological wellbeing of patients. Various patient characteristics affect the impact of GTD diagnosis.
评估妊娠滋养细胞疾病（GTD）的短期心理后果。
前瞻性观察性多中心队列研究。
荷兰全国范围内。
GTD 患者。
诊断后立即进行在线问卷调查。
医院焦虑抑郁量表（HADS）、痛苦温度计（DT）、事件影响量表（IES）和生殖关注量表（RCS）。
2017 年至 2020 年期间，共纳入 60 例 GTD 患者。焦虑感（47%）比抑郁感（27%）更常见。88%的患者出现了中重度适应问题。有子女的患者对生殖能力的担忧程度低于无子女的患者（平均得分为 10.4 对 15.0，P=0.031），且有子女的患者痛苦水平较低（IES 平均得分为 25.7 对 34.7，P=0.020）。此外，与无妊娠丢失的患者相比，有既往妊娠丢失的患者的痛苦评分较低（IES 平均得分为 21.1 对 34.2，P=0.002）。
我们建议医生监测患者的身体不适和心理健康状况随时间的变化，以便及时为那些基线时压力较大的患者提供个性化的支持性护理。
GTD 患者经历了更高水平的痛苦、焦虑和抑郁，这表明该诊断对患者的心理健康有重大影响。有子女或有既往妊娠丢失的患者，GTD 诊断对侵入和回避的影响似乎有所减轻。
妊娠滋养细胞疾病（GTD）患者经历短期心理后果，如痛苦、焦虑和抑郁，表明 GTD 诊断对患者的心理健康有重大影响。各种患者特征会影响 GTD 诊断的影响。
