Wang Xiaowen, Li Min, Shi Qiong, Ji Hongchen, Kong Shengnan, Zhu Lei, Zhang Hong-Mei
Department of Clinical Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Department of Neurosurgery, Shaanxi Provincial People's Hospital, Xi'an, China.
Front Psychiatry. 2022 Apr 26;13:880978. doi: 10.3389/fpsyt.2022.880978. eCollection 2022.
The novel coronavirus disease 2019 (COVID-19) pandemic causes great disruption to cancer care services, which might bring about psychological problems and further lower both physical and mental life quality in cancer patients. Until now, very few studies focused on the psychological distress of patients with advanced melanoma before or during the epidemic. This study aimed to elucidate the fear of progression (FoP), anxiety, depression, and related independent predictors in patients with advanced melanoma during the COVID-19 outbreak.
Two hundred and seventy-three patients with unresectable stage III or metastatic melanoma were recruited from February 2020 to November 2021, and completed the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), State Trait Anxiety Inventory (STAI-6), and Patient Health Questionnaire (PHQ-9).
One hundred and seventy-four (64.7%) patients experienced heighted FoP (FoP-Q-SF: 39.9 ± 11.0), 198 (72.5%) patients reported elevated anxiety (STAI-6: 13.1 ± 3.0), and 62 (22.7%) patients had increased depression (PHQ-9: 6.4 ± 6.1). In multivariate analysis, illness duration ( = 0.987 for FoP; = 0.984 for depression), cancer stage ( = 14.394 for anxiety) and disease progression ( = 1.960 for FoP; = 23.235 for anxiety; = 1.930 for depression) were independent predictors for FoP, anxiety or depression. Additionally, the high levels of FoP, anxiety and depression were significantly positive correlated with each other ( = 0.466 for FoP and anxiety; = 0.382 for FoP and depression; = 0.309 for anxiety and depression).
Our study indicates that FoP, anxiety and depression are persisting among patients with advanced melanoma in the COVID-19 and post-COVID-19 era. Effective psycho-oncological interventions are needed for melanoma patients with psychological distress during the ongoing COVID-19 pandemic.
2019年新型冠状病毒病（COVID-19）大流行对癌症护理服务造成了极大干扰，这可能导致心理问题，并进一步降低癌症患者的身心健康生活质量。到目前为止，很少有研究关注晚期黑色素瘤患者在疫情之前或期间的心理困扰。本研究旨在阐明COVID-19疫情期间晚期黑色素瘤患者的疾病进展恐惧（FoP）、焦虑、抑郁及相关独立预测因素。
2020年2月至2021年11月招募了273例不可切除的III期或转移性黑色素瘤患者，他们完成了疾病进展恐惧问卷简表（FoP-Q-SF）、状态特质焦虑量表（STAI-6）和患者健康问卷（PHQ-9）。
174例（64.7%）患者经历了较高的疾病进展恐惧（FoP-Q-SF：39.9±11.0），198例（72.5%）患者报告焦虑情绪升高（STAI-6：13.1±3.0），62例（22.7%）患者出现抑郁加重（PHQ-9：6.4±6.1）。多因素分析显示，病程（疾病进展恐惧的β=0.987；抑郁的β=0.984）、癌症分期（焦虑的β=14.394）和疾病进展（疾病进展恐惧的β=1.960；焦虑的β=23.235；抑郁的β=1.930）是疾病进展恐惧、焦虑或抑郁的独立预测因素。此外，高水平的疾病进展恐惧、焦虑和抑郁之间显著正相关（疾病进展恐惧与焦虑的r=0.466；疾病进展恐惧与抑郁的r=0.382；焦虑与抑郁的r=0.309）。
我们的研究表明，在COVID-19及后COVID-19时代，晚期黑色素瘤患者中持续存在疾病进展恐惧、焦虑和抑郁。在当前COVID-19大流行期间，需要对有心理困扰的黑色素瘤患者进行有效的心理肿瘤学干预。
