Lopes Catarina, Severo Milton, Fontes Filipa, Lopes-Conceição Luisa, Ferreira Augusto, Pereira Susana, Lunet Nuno, Araújo Natália
EPIUnit-Instituto de Saude Publica, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal.
Laboratorio para a Investigaçao Integrativa e Translacional em Saude Populacional (ITR), Rua das Taipas, 135, 4050-600 Porto, Portugal.
Healthcare (Basel). 2022 Mar 31;10(4):661. doi: 10.3390/healthcare10040661.
Anxiety and depression symptoms are frequent among patients with breast cancer (BCa) and may last after initial treatments. We aimed to identify five-year trajectories of anxiety and depression symptoms among women with BCa. Neuro-oncological complications of BCa (NEON-BC) cohort included 506 patients admitted at the Portuguese Institute of Oncology of Porto in 2012, who were evaluated with the Hospital Anxiety and Depression Scale before cancer treatment and after one, three, and five years (7.9% attrition rate). Mixed-effect models were used to model anxiety and depression scores over time and model-based clustering to identify the different trajectories. Three trajectories of anxiety symptoms were identified: (1) high scores at baseline and increasing over time (21.7%); (2) consistently low scores over time (63.6%); (3) mid-range scores at baseline, decreasing over time (14.6%). Three trajectories were identified for depression symptoms: (1) high scores at baseline and increasing over time (21.1%); (2) mid-range scores at baseline, which decreased afterward (58.7%); (3) consistently low levels over time (20.2%). Age, education, baseline, and one-year anxiety/depression status predicted the worst five-year trajectories. These results show that assessing anxiety and depression symptoms before treatment and after one year may contribute to identifying the patients who could benefit the most from psychological support.
焦虑和抑郁症状在乳腺癌（BCa）患者中很常见，并且可能在初始治疗后持续存在。我们旨在确定BCa女性患者焦虑和抑郁症状的五年轨迹。BCa神经肿瘤并发症（NEON-BC）队列包括2012年在波尔图葡萄牙肿瘤研究所收治的506例患者，这些患者在癌症治疗前以及治疗后1年、3年和5年接受了医院焦虑抑郁量表评估（失访率为7.9%）。使用混合效应模型对焦虑和抑郁评分随时间的变化进行建模，并使用基于模型的聚类来识别不同的轨迹。确定了焦虑症状的三种轨迹：（1）基线时得分高且随时间增加（21.7%）；（2）随时间始终得分低（63.6%）；（3）基线时得分中等，随时间下降（14.6%）。确定了抑郁症状的三种轨迹：（1）基线时得分高且随时间增加（21.1%）；（2）基线时得分中等，随后下降（58.7%）；（3）随时间始终处于低水平（20.2%）。年龄、教育程度、基线以及1年时的焦虑/抑郁状态可预测最差的五年轨迹。这些结果表明，在治疗前和治疗后1年评估焦虑和抑郁症状可能有助于识别那些最能从心理支持中受益的患者。
