Department of Psychiatry, Guangdong 999 Brain Hospital, Guangzhou, China.
Department of Nursing, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China.
Front Public Health. 2022 Oct 10;10:1002341. doi: 10.3389/fpubh.2022.1002341. eCollection 2022.
The aim of the current study is to investigate the change in anxiety and depression amongst Chinese breast cancer patients and to identify causal associations between baseline variables and the trajectory of anxiety and depression within this identified group.
This is a longitudinal prospective study. Three hundred women with breast cancer were recruited. Patient's depression and anxiety were repeatedly measured by PHQ-9 and GAD-7 at baseline, 6, 12, and 18 months after discharge. The SAS 9.4 PROC Traj procedure was used to examine the group-based trajectory of these recruited patients. Linear mixed models (LMM) were utilized to examine anxiety/depression changes over time, accounting for relevant baseline demographic and clinical factors.
About 26.3% of the participants reported none or very mild anxiety over time, 60.7% reported stable low-level anxiety, and the remaining 13.0% showed significantly decreasing trend in GAD total scores. Meanwhile, 10.7% of the participants reported none or very mild depressive symptoms over time, 66.0% reported stable PHQ total scores throughout the research period, and 23.3% were classified as the "high level-decreasing group". Patients reported significantly higher anxiety and depression scores in the first three assessments. Participants with no or mild life stress along with a positive personality tended to report lower anxiety and depression scores over time.
Most of the breast cancer patients reported stable low-level anxiety and depression 18 months after discharge. Early assessment of optimism and stress levels among cancer patients might help identify people at risk of experiencing long-term anxiety and depression.
本研究旨在调查中国乳腺癌患者的焦虑和抑郁变化，并确定基线变量与该特定群体中焦虑和抑郁轨迹之间的因果关联。
这是一项纵向前瞻性研究。共招募了 300 名乳腺癌患者。患者的抑郁和焦虑状态分别采用 PHQ-9 和 GAD-7 在基线、出院后 6、12 和 18 个月时进行重复测量。采用 SAS 9.4 PROC Traj 程序来检测这些患者的群组轨迹。利用线性混合模型（LMM）来检测随时间变化的焦虑/抑郁变化，并考虑相关的基线人口统计学和临床因素。
约 26.3%的参与者报告在整个时间内无或轻度焦虑，60.7%报告稳定的低水平焦虑，其余 13.0%的患者 GAD 总分呈明显下降趋势。同时，10.7%的参与者报告在整个研究期间无或轻度抑郁症状，66.0%报告 PHQ 总分稳定，23.3%被归类为“高水平下降组”。患者在前三次评估中报告的焦虑和抑郁评分明显较高。生活压力小或无生活压力且性格积极的患者随着时间的推移往往报告焦虑和抑郁评分较低。
大多数乳腺癌患者在出院后 18 个月时报告稳定的低水平焦虑和抑郁。早期评估癌症患者的乐观和压力水平可能有助于识别存在长期焦虑和抑郁风险的人群。
