Dinkel Andreas, Marten-Mittag Birgitt, Kremsreiter Katrin
Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, University Medical Center Mannheim, Mannheim, Germany.
Front Psychol. 2021 Aug 11;12:648623. doi: 10.3389/fpsyg.2021.648623. eCollection 2021.
Fear of progression (FoP), or fear of cancer recurrence (FCR), is characterized by worries or concerns about negative illness-related future events. Actually, to worry is a common cognitive process that, in its non-pathological form, belongs to daily life. However, worry can also become pathological appearing as a symptom of mental disorders. This study aimed at investigating the associations among daily worry, pathological worry, and FoP in patients with cancer. This is a cross-sectional study that includes 328 hospitalized patients with cancer. Patients filled out the FoP Questionnaire (FoP-Q), the Worry Domains Questionnaire (WDQ) for the assessment of daily worry, and the Penn State Worry Questionnaire (PSWQ) for the assessment of pathological worry. Depressive, anxiety, and somatic symptoms were measured with modules of the Patient Health Questionnaire [Patient Health Questionnaire-Depressive Symptoms (PHQ-2), Generalized Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire-Somatic Symptoms (PHQ-15)]. Furthermore, a structured clinical interview was conducted for the assessment of anxiety disorders. The hierarchical multiple linear regression analysis was used to identify factors independently associated with FoP. Mean age of the participants was = 58.5 years (SD = 12.8), and 64.6% were men. FoP and worry were significantly intercorrelated ( = 0.58-0.78). The level of FoP was most strongly associated with daily worry ( = 0.514, < 0.001), followed by pathological worry ( = 0.221, < 0.001). Further significant determinants were younger age and depressive and anxiety symptoms. Clinical variables were not independently associated with FoP. The final model explained 74% of the variance. Fear of progression is strongly associated with daily worry and pathological worry. These results bring up the question of whether FoP is an expression of a general tendency to worry. Whether a general tendency to worry, in fact, represents an independent vulnerability factor for experiencing FCR/FoP needs to be investigated in a longitudinal research design.
疾病进展恐惧（FoP），或癌症复发恐惧（FCR），其特征是对与疾病相关的负面未来事件感到担忧。实际上，担忧是一种常见的认知过程，在非病理形式下，它属于日常生活。然而，担忧也可能变得病态，成为精神障碍的一种症状。本研究旨在调查癌症患者的日常担忧、病态担忧与疾病进展恐惧之间的关联。这是一项横断面研究，纳入了328名住院癌症患者。患者填写了疾病进展恐惧问卷（FoP-Q）、用于评估日常担忧的担忧领域问卷（WDQ）以及用于评估病态担忧的宾夕法尼亚州立大学担忧问卷（PSWQ）。使用患者健康问卷的模块[患者健康问卷-抑郁症状（PHQ-2）、广泛性焦虑障碍-2（GAD-2）和患者健康问卷-躯体症状（PHQ-15）]来测量抑郁、焦虑和躯体症状。此外，进行了结构化临床访谈以评估焦虑障碍。采用分层多元线性回归分析来确定与疾病进展恐惧独立相关的因素。参与者的平均年龄为58.5岁（标准差=12.8），64.6%为男性。疾病进展恐惧与担忧显著相互关联（相关系数=0.58 - 0.78）。疾病进展恐惧水平与日常担忧的关联最为紧密（相关系数=0.514，P<0.001），其次是病态担忧（相关系数=0.221，P<0.001）。其他显著的决定因素包括年龄较小以及抑郁和焦虑症状。临床变量与疾病进展恐惧无独立关联。最终模型解释了74%的方差。疾病进展恐惧与日常担忧和病态担忧密切相关。这些结果引发了一个问题，即疾病进展恐惧是否是一种普遍担忧倾向的表现。事实上，一种普遍的担忧倾向是否代表了经历癌症复发恐惧/疾病进展恐惧的独立易感性因素，需要在纵向研究设计中进行调查。
