Zhan Ze-Jiang, Huang Hao-Yang, Xiao Yan-Hua, Zhao Yu-Ping, Cao Xun, Cai Zhuo-Chen, Huang Ying-Ying, Chen Xi, Deng Ying, Zhou Jia-Yu, Zhang Lu-Lu, Luo Zhuo-Ying, Qiu Wen-Ze, Yuan Tai-Ze, Hu Wen, Fan Yu-Ying, Mai Hai-Qiang, Yang Yuan, Guo Xiang, Lv Xing
Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou 510060, P. R. China.
Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, P. R. China.
Radiother Oncol. 2024 Aug;197:110324. doi: 10.1016/j.radonc.2024.110324. Epub 2024 May 10.
To determine the prevalence of anxiety and depression in patients with nasopharyngeal carcinoma (NPC) and to identify central symptoms and bridge symptoms among psychiatric disorders.
This cross-sectional study recruited patients with NPC in Guangzhou, China from May 2022, to October 2022. The General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used for screening anxiety and depression, respectively. Network analysis was conducted to evaluate the centrality and connectivity of the symptoms of anxiety, depression, quality of life (QoL) and insomnia.
A total of 2806 respondents with complete GAD-7 and PHQ-9 scores out of 3828 were enrolled. The incidence of anxiety in the whole population was 26.5% (depression, 28.5%; either anxiety or depression, 34.8%). Anxiety was highest at caner diagnosis (34.2%), while depression reached a peak at late-stage radiotherapy (48.5%). Both moderate and severe anxiety and depression were exacerbated during radiotherapy. Coexisting anxiety and depression occurred in 58.3% of those with either anxiety or depression. The generated network showed that anxiety and depression symptoms were closely connected; insomnia was strongly connected with QoL. "Sad mood", "Lack of energy", and "Trouble relaxing" were the most important items in the network. Insomnia was the most significant bridge item that connected symptom groups.
Patients with NPC are facing alarming disturbances of psychiatric disorders; tailored strategies should be implemented for high-risk patients. Besides, central symptoms (sad mood, lack of energy, and trouble relaxing) and bridge symptoms (insomnia) may be potential interventional targets in future clinical practice.
确定鼻咽癌（NPC）患者焦虑和抑郁的患病率，并识别精神障碍中的核心症状和桥梁症状。
这项横断面研究于2022年5月至2022年10月在中国广州招募了鼻咽癌患者。分别使用广泛性焦虑障碍量表-7（GAD-7）和患者健康问卷-9（PHQ-9）筛查焦虑和抑郁。进行网络分析以评估焦虑、抑郁、生活质量（QoL）和失眠症状的中心性和连通性。
在3828名受访者中，共有2806名GAD-7和PHQ-9评分完整的受访者被纳入研究。总体人群中焦虑的发生率为26.5%（抑郁为28.5%；焦虑或抑郁为34.8%）。焦虑在癌症诊断时最高（34.2%），而抑郁在放疗后期达到峰值（48.5%）。在放疗期间，中度和重度焦虑及抑郁均加重。焦虑和抑郁并存的情况发生在焦虑或抑郁患者中的58.3%。生成的网络显示焦虑和抑郁症状紧密相连；失眠与生活质量密切相关。“情绪悲伤”“精力不足”和“难以放松”是网络中最重要的项目。失眠是连接症状组的最重要桥梁项目。
鼻咽癌患者面临着令人担忧的精神障碍困扰；应针对高危患者实施量身定制的策略。此外，核心症状（情绪悲伤、精力不足和难以放松）和桥梁症状（失眠）可能是未来临床实践中的潜在干预靶点。
