Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China.
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, P. R. China.
Clin Respir J. 2023 Mar;17(3):157-164. doi: 10.1111/crj.13576. Epub 2023 Jan 18.
This study focuses on the prevalence and characteristics of anxiety in patients with pulmonary nodules that was assessed by Hamilton Anxiety Scale (HAMA) scores. A total of 890 patients were enrolled in this study, including incidence of absence of anxiety n = 343 (38.54%), mild or probable anxiety n = 459 (51.57%) and moderate or definite anxiety n = 79 (8.88%) and obvious anxiety n = 9 (1.01%), respectively. According to the definition of anxiety, 88 (9.89%) patients were enrolled in anxiety group. The incidence of anxiety in females was significantly higher than male (11.98% vs. 7.20%, p = 0.018), patients with respiratory symptoms were significantly higher than without respiratory symptoms (13.33% vs. 8.50%, p = 0.029) and diameter of pulmonary nodules >8 mm is significantly higher than ≤8 mm (13.35% vs. 7.10%, p = 0.002). Regression analysis showed that female (OR = 0.548, 95% CI: 0.340-0.884), family history of malignant tumour (OR = 1.691, 95% CI: 1.067-2.678), respiratory symptoms (OR = 1.713, 95% CI: 1.073-2.733) and diameter >8 mm (OR = 2.135, 95% CI: 1.350-3.375) were independent risk factors of anxiety. Further analysis of 88 patients with anxiety showed the sum of psychic anxiety was significantly higher than somatic anxiety (16.66 ± 2.46 vs. 0.97 ± 1.10, p < 0.0001). Hence, vast majority of patients with unconfirmed pulmonary nodules suffered various severity of anxiety and manifested as psychic anxiety. And gender, respiratory symptoms, family history of malignant tumour and diameter of pulmonary nodules were independent influencing factors of anxiety. Effective strategies urgently need exploring and providing for improving the mental health.
本研究通过汉密尔顿焦虑量表(HAMA)评分评估了肺部结节患者焦虑的发生率和特征。共有 890 名患者入组本研究,其中无焦虑发生率为 343 例(38.54%),轻度或可能焦虑发生率为 459 例(51.57%),中度或明确焦虑发生率为 79 例(8.88%),明显焦虑发生率为 9 例(1.01%)。根据焦虑的定义,88 例(9.89%)患者被纳入焦虑组。女性焦虑发生率明显高于男性(11.98%比 7.20%,p=0.018),有呼吸系统症状的患者明显高于无呼吸系统症状的患者(13.33%比 8.50%,p=0.029),且肺部结节直径>8mm 的患者明显高于直径≤8mm 的患者(13.35%比 7.10%,p=0.002)。回归分析显示,女性(OR=0.548,95%CI:0.340-0.884)、恶性肿瘤家族史(OR=1.691,95%CI:1.067-2.678)、呼吸系统症状(OR=1.713,95%CI:1.073-2.733)和直径>8mm(OR=2.135,95%CI:1.350-3.375)是焦虑的独立危险因素。对 88 例焦虑患者进一步分析显示,精神焦虑总分明显高于躯体焦虑(16.66±2.46比 0.97±1.10,p<0.0001)。因此,大多数未确诊的肺部结节患者存在不同程度的焦虑,表现为精神焦虑。性别、呼吸系统症状、恶性肿瘤家族史和肺部结节直径是焦虑的独立影响因素。迫切需要探索和提供有效的策略来改善心理健康。