Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Department of Breast Cancer Radiotherapy, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
Cancer Med. 2024 Jun;13(11):e7330. doi: 10.1002/cam4.7330.
Patients with advanced colorectal cancer (CRC) have multiple concurrent physical and psychological symptoms. This study aimed to explore the relationship between anxiety, depression, and symptom burden in advanced CRC.
A multicenter cross-sectional study was conducted in 10 cancer centers from geographically and economically diverse sites in China. A total of 454 patients with advanced CRC completed the Hospital Anxiety and Depression Scale and the MD Anderson Symptom Inventory. Multiple regression analysis was applied to explore the relationship between anxiety, depression and symptom burden.
About one-third of the patients showed symptoms of anxiety or depression. Patients with anxiety or depression reported significantly higher symptom burden than those without (p < 0.001). Patients with anxiety or depression reported a higher proportion of moderate-to-severe (MS) symptom number than those without (p < 0.001). About 52% of the patients with anxiety or depression reported at least three MS symptoms. The prevalence of MS symptoms was ranging from 7.3% (shortness of breath) to 22% (disturbed sleep), and in patients with anxiety or depression was 2-10 times higher than in those without (p < 0.001). Disease stage (β = -2.55, p = 0.003), anxiety (β = 15.33, p < 0.001), and depression (β = 13.63, p < 0.001) were associated with higher symptom burden.
Anxiety and depression in patients with advanced cancer correlated with higher symptom burden. Findings may lead oncology professionals to pay more attention to unrecognized and untreated psychological symptoms in symptom management for advanced cancer patients.
晚期结直肠癌（CRC）患者存在多种并存的躯体和心理症状。本研究旨在探讨晚期 CRC 患者焦虑、抑郁与症状负担之间的关系。
本研究为多中心横断面研究，在中国地理位置和经济条件各异的 10 家癌症中心进行。共纳入 454 例晚期 CRC 患者，完成医院焦虑抑郁量表和 MD 安德森症状评估量表。采用多元回归分析探讨焦虑、抑郁与症状负担之间的关系。
约三分之一的患者出现焦虑或抑郁症状。焦虑或抑郁患者的症状负担明显高于无焦虑或抑郁的患者（p<0.001）。焦虑或抑郁患者报告中至重度症状数的比例明显高于无焦虑或抑郁的患者（p<0.001）。约 52%的焦虑或抑郁患者报告至少有 3 项中至重度症状。中至重度症状的发生率为 7.3%（呼吸急促）至 22%（睡眠障碍），焦虑或抑郁患者的发生率是无焦虑或抑郁患者的 2-10 倍（p<0.001）。疾病分期（β=-2.55，p=0.003）、焦虑（β=15.33，p<0.001）和抑郁（β=13.63，p<0.001）与更高的症状负担相关。
晚期癌症患者的焦虑和抑郁与更高的症状负担相关。研究结果可能促使肿瘤专业人员在晚期癌症患者的症状管理中更加关注未被识别和未治疗的心理症状。
