Department of Surgery and Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Jan;27(2):704-712. doi: 10.26355/eurrev_202301_31073.
Patients with chronic disease whose treatments are limited may experience depression, anxiety, and stress-related symptoms, as well as an increase in the levels of these conditions. This study aims to determine the factors affecting the depression, stress, and anxiety levels of hepatocellular carcinoma (HCC) patients due to the fear of COVID-19 exposure.
118 patients with advanced HCC treated with non-transplant treatment options or on the waiting list due to the lack of a donor were enrolled. To evaluate the stress, depression, and anxiety levels during the COVID-19 process, Depression Anxiety Stress Scales (DASS-21) and the Coronavirus Anxiety Scale (CAS) were administered to 118 patients through a face-to-face interview. Sociodemographic and clinical characteristics were recorded, and the primary endpoint measure was the total score of DASS. In addition, the multilayer perceptron (MLP) model was constructed to predict the scores of the DASS-21 total.
There were significant differences between DASS depression (p=0.010; p=0.030) DASS anxiety (p=0.010; p=0.010) and DASS total (p=0.046; p=0.023) scores in terms of gender and protective effect of the vaccine. Also, a significant difference between gender for the CAS scale was determined (p=0.044). The median score of the DASS total in the COVID-19 group was higher than in the non-COVID-19 group; however, the increase was not significant. MLP model revealed that chronic disease, gender, age, place of residence, smoking, type of vaccine, and COVID-19 exposure were the most important predictors for the DASS total.
Chronic disease, gender, and age were prominent factors in predicting the DASS-21 total score in HCC patients. Therefore, the crucial factors were clinically considered for managing depression, stress, and anxiety in HCC patients.
治疗受限的慢性病患者可能会经历抑郁、焦虑和与压力相关的症状，以及这些病症水平的升高。本研究旨在确定因担心 COVID-19 暴露而导致肝癌 (HCC) 患者抑郁、压力和焦虑水平的影响因素。
共纳入 118 例接受非移植治疗选择或因缺乏供体而在等待名单上的晚期 HCC 患者。为了评估 COVID-19 期间的压力、抑郁和焦虑水平，通过面对面访谈向 118 例患者发放抑郁焦虑压力量表 (DASS-21) 和冠状病毒焦虑量表 (CAS)。记录社会人口统计学和临床特征，主要终点测量指标为 DASS 总分。此外，还构建了多层感知器 (MLP) 模型来预测 DASS-21 总分的分数。
在 DASS 抑郁 (p=0.010;p=0.030)、DASS 焦虑 (p=0.010;p=0.010) 和 DASS 总分 (p=0.046;p=0.023) 方面，性别存在显著差异，疫苗具有保护作用。此外，还确定了 CAS 量表在性别方面存在显著差异 (p=0.044)。COVID-19 组的 DASS 总分中位数高于非 COVID-19 组，但差异无统计学意义。MLP 模型显示，慢性病、性别、年龄、居住地、吸烟、疫苗类型和 COVID-19 暴露是 DASS 总分的最重要预测因素。
慢性病、性别和年龄是预测 HCC 患者 DASS-21 总分的重要因素。因此，在管理 HCC 患者的抑郁、压力和焦虑时，应从临床角度考虑这些关键因素。
