Hals-Nasen-Ohren Klinik und Poliklinik, Klinikum Rechts der Isar, Technischen Universität München, Ismaningerstr. 22, 81675, München, Deutschland.
Klinik für Strahlentherapie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.
Eur Arch Otorhinolaryngol. 2022 Apr;279(4):2143-2156. doi: 10.1007/s00405-021-07017-8. Epub 2021 Aug 18.
Cancer and morbidity during a therapeutic regimen can result in somatic and psychiatric impairment. We have evaluated the need of appropriate psychological screening by analyzing a large collective of head and neck cancer (HNC) patients with particularly burdensome symptoms.
HNC-aftercare patients were asked about somatic and psychological symptoms by means of standardized questionnaires of the European Organization for Research and Treatment of Cancer (EORTC Q30 and QLQ-H&N35). Patients with poor well-being values on the World Health Organization-5-Well-Being Index were screened for depression by using the Mini International Neuropsychiatric Interview, and adequate treatment was initiated, if necessary.
Our sample consisted of 453 HNC-aftercare patients (average age 64.5 years; 72.0% male; 28.0% female). 25.1% showed abnormalities based on their WHO-5 questionnaire. A current major depressive episode was observed in 8.5% of the total study group. Patients with lip and oral cavity tumors showed the highest depression prevalence (18.9%). Time since initial HNC diagnosis showed no clear trend with regard to the number of depression cases. 50.0% of patients with a current major depressive episode consented to receiving assistance and/or therapy. Within the total study population, the most burdensome symptoms were found to be "dry mouth" (48.3%), "trouble doing strenuous activities" (46.0%), "trouble taking a long walk" (38.5%), and "worry" (35.5%). Aftercare patients with a depression diagnosis tended to have heavier symptom burdens than people without major depression.
Despite the various cancer-related burdensome factors, prevalence levels of depression among the HNC-aftercare patients and the general population were similar. Nevertheless, since the number of diagnosed depression cases is high, the need for psychological treatment should be considered within the tumor collective. Furthermore, screening for depression should be implemented in clinical routines by using the appropriate standardized questionnaires.
癌症和治疗期间的发病率可能导致躯体和精神障碍。我们通过分析大量患有严重症状的头颈部癌症（HNC）患者，评估了进行适当心理筛查的必要性。
通过欧洲癌症研究与治疗组织（EORTC）的 Q30 和 QLQ-H＆N35 标准化问卷，对头颈部癌症康复患者进行躯体和心理症状调查。采用 Mini 国际神经精神访谈对世界卫生组织-5 项健康指数（WHO-5）评分差的患者进行抑郁筛查，如果需要，就进行适当的治疗。
我们的样本包括 453 例头颈部癌症康复患者（平均年龄 64.5 岁；72.0%为男性；28.0%为女性）。根据 WHO-5 问卷，25.1%的患者存在异常。在总研究组中，有 8.5%的患者出现当前的重度抑郁发作。唇和口腔肿瘤患者的抑郁患病率最高（18.9%）。从初始 HNC 诊断到现在的时间与抑郁病例数之间没有明显的趋势。有当前重度抑郁发作的 50.0%患者愿意接受帮助和/或治疗。在总研究人群中，最严重的症状是“口干”（48.3%）、“难以进行剧烈活动”（46.0%）、“难以长距离行走”（38.5%）和“担忧”（35.5%）。诊断为抑郁症的康复患者的症状负担往往比没有重度抑郁症的患者更重。
尽管存在各种与癌症相关的负担因素，但 HNC 康复患者和一般人群的抑郁症患病率相似。然而，由于诊断出的抑郁症病例数量较多，因此应考虑在肿瘤群体中进行心理治疗。此外，应通过使用适当的标准化问卷，在临床常规中实施抑郁筛查。
