Andra Oltean, Pintea Cezara, Manea Andrei, Nirestean Aurel, Niculescu Raluca, Gîrbovan Mircea, Elena-Gabriela Strete
Department of Psychiatry, Emergency Clinical County Hospital of Târgu Mureș, Târgu Mureș, ROU.
Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, ROU.
Cureus. 2024 Jul 31;16(7):e65870. doi: 10.7759/cureus.65870. eCollection 2024 Jul.
Background and aim Psychiatric pathology does not always start on its own but may be conditioned or triggered by a comorbidity with a high impact on the human psyche. When there are comorbidities, psychiatric pathology can occur due to the high diagnostic burden. Our study aims to find out if there is a correlation between the diagnosis of breast cancer and its severity, and psychiatric symptoms such as depressive mood, atypical anxiety, or even autolytic ideation that directly influence the quality of life of patients. Materials and methods The study is a prospective, cross-sectional, single-center study carried out between December 2023 and June 2024 at the Mureș County Clinical Hospital in Romania. The sample population had to be at least 18 years old and had to be diagnosed with breast cancer recently. We applied two tests, WHODAS 2 (World Health Organization's Disability Assessment Schedule 2.0) and level 1 (level 1 of cross-sectional measurements of symptoms), to be able to measure and aid assessment of mental health domains that are important across psychiatric diagnoses and also the degree of disability triggered by breast cancer. The statistical analysis included descriptive statistics and interferential statistics. Statistical tests, such as Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney U tests with Bonferroni correction tests, were used. The p-value was set to 0.05 with a confidence interval (CI) of 95%. Results The study included 120 women diagnosed with breast cancer, with a mean age of 56.64 ± 9.46 years. Regarding the severity of the diagnosis, 44 women (36.66%) had non-invasive cancer, 58 (48.33%) had invasive cancer, and 18 (15%) had metastases. There was a statistically significant difference between three of the five selected level 1 domains across cancer types. The WHODAS 2.0 disability scores showed a significant difference between groups (p < 0.001). Subjects with non-invasive cancer had the lowest WHODAS 2.0 score, followed by the invasive group, while metastases had the highest score. Conclusions Following the application of the two tests, level 1 and WHODAS 2.0, to our group of subjects, statistically significant differences were observed between the three categories of subjects. The degree of disability and the occurrence of psychological symptoms differed according to the severity of breast cancer. Adapting to the status of an oncological patient entails multiple changes from a psycho-emotional, social, occupational, and professional point of view. Although the most recent medications prolong survival, a holistic approach that considers psychological aspects can improve patients' long-term results.
背景与目的 精神病理学并非总是独立出现,而是可能由对人类心理有重大影响的合并症所引发或促成。当存在合并症时,由于诊断负担过重,可能会出现精神病理学症状。我们的研究旨在探究乳腺癌的诊断及其严重程度与诸如抑郁情绪、非典型焦虑甚至自伤观念等精神症状之间是否存在关联,这些精神症状会直接影响患者的生活质量。
材料与方法 本研究是一项前瞻性、横断面、单中心研究,于2023年12月至2024年6月在罗马尼亚穆列什县临床医院开展。样本人群必须年满18岁且最近被诊断患有乳腺癌。我们应用了两项测试,即WHODAS 2(世界卫生组织残疾评估量表2.0)和1级(症状横断面测量的1级),以便能够测量并辅助评估在各种精神诊断中都很重要的心理健康领域,以及乳腺癌引发的残疾程度。统计分析包括描述性统计和推断性统计。使用了诸如Shapiro-Wilk检验、Kruskal-Wallis检验以及经Bonferroni校正检验的Mann-Whitney U检验等统计测试。将p值设定为0.05,置信区间(CI)为95%。
结果 该研究纳入了120名被诊断患有乳腺癌的女性,平均年龄为56.64±9.46岁。关于诊断的严重程度,44名女性(36.66%)患有非浸润性癌,58名(48.33%)患有浸润性癌,18名(15%)患有转移癌。在所选的五个1级领域中的三个领域,不同癌症类型之间存在统计学上的显著差异。WHODAS 2.0残疾评分在各组之间显示出显著差异(p<0.001)。非浸润性癌患者的WHODAS 2.0评分最低,其次是浸润性癌组,而转移癌患者的评分最高。
结论 在对我们的研究对象群体应用1级和WHODAS 2.0这两项测试后,在三类研究对象之间观察到了统计学上的显著差异。残疾程度和心理症状的出现因乳腺癌的严重程度而异。从心理情感、社会、职业和专业角度来看,适应肿瘤患者的状态需要经历多重变化。尽管最新的药物延长了生存期,但考虑心理方面的整体方法可以改善患者的长期预后。