Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Psychooncology. 2022 Jul;31(7):1102-1109. doi: 10.1002/pon.5896. Epub 2022 Feb 12.
Around 25% of cancer patients experiences depressive symptoms. However, the majority does not receive formal psychological care because patients often prefer managing symptoms alone or with informal social support. Previous research has shown that adaptive coping and social support can indeed be effective in managing relatively mild depressive symptoms. However, higher depressive symptom levels rarely improve without psychological treatment. This longitudinal study examined how and to what extent coping and social support are related to reductions in depressive symptoms in cancer patients with moderate to severe depressive symptoms.
Respondents were diagnosed with cancer in the past five years, experienced high depressive symptom levels (PHQ-9 ≥ 10) and were not receiving psychological care at baseline. We collected data with self-report questionnaires (including PHQ-9, brief COPE and Social Support List) at two assessments, taken three months apart.
Although depressive symptoms decreased significantly between baseline and follow-up, the average level at follow-up was still moderate to severe. Patients using less avoidant coping, specifically less substance use, were more likely to report a reduction of depressive symptoms. We found no significant beneficial effects of approach coping and social support (coping) on the course of depressive symptoms.
A significant group of cancer patients with high levels of depressive symptoms do not seem able to effectively manage depressive symptoms by themselves, especially those more likely to avoid dealing with their symptoms. Cancer patients can be educated about avoidant coping and its possible detrimental effects, as well as being informed about possibilities of psychosocial services.
约 25%的癌症患者会出现抑郁症状。然而，由于患者通常更愿意独自或通过非正式的社会支持来管理症状，因此大多数患者并未接受正式的心理护理。先前的研究表明，适应性应对和社会支持确实可以有效管理相对轻度的抑郁症状。然而，较高水平的抑郁症状在没有心理治疗的情况下很少会改善。本纵向研究旨在探讨应对方式和社会支持与中重度抑郁癌症患者抑郁症状减轻之间的关系和程度。
受访者在过去五年内被诊断出患有癌症，在基线时表现出较高的抑郁症状水平（PHQ-9≥10），且未接受心理护理。我们使用自我报告问卷（包括 PHQ-9、简要应对方式量表和社会支持量表）在两次评估中收集数据，两次评估之间相隔三个月。
尽管抑郁症状在基线和随访之间显著下降，但随访时的平均水平仍为中重度。使用较少回避应对方式（特别是较少使用物质）的患者更有可能报告抑郁症状减轻。我们未发现应对方式和社会支持（应对）对抑郁症状发展有显著的有益影响。
相当一部分高水平抑郁症状的癌症患者似乎无法通过自身有效地管理抑郁症状，尤其是那些更倾向于回避处理症状的患者。可以对癌症患者进行有关回避应对及其可能产生的不利影响的教育，并告知他们获得心理社会服务的可能性。
