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分化型甲状腺癌患者放射性碘治疗前后的心理健康与生活质量:一项前瞻性研究。

Mental Health and Quality of Life of Patients with Differentiated Thyroid Cancer Pre and Post Radioactive Iodine Treatment: A Prospective Study.

作者信息

Changchien Te-Chang, Yen Yung-Chieh, Lu Yung-Chuan

机构信息

Department of Psychiatry, E-Da Hospital, Kaohsiung City 824, Taiwan.

School of Medicine, I-Shou University, Kaohsiung City 824, Taiwan.

出版信息

J Clin Med. 2024 Sep 14;13(18):5472. doi: 10.3390/jcm13185472.

Abstract

: Although patients with differentiated thyroid cancer (DTC) have a good prognosis, their long-term clinical course can influence their mental health and their health-related quality of life (HRQoL). However, few studies have evaluated the psychological factors that influence subsequent HRQoL in this population, particularly during the initial treatment stage. : In this 1-month cohort study, we evaluated depressive and anxiety symptoms and HRQoL of patients with DTC and examined possible predictors of further HRQoL impairment. : In total, 181 patients completed questionnaires where they self-rated their psychological status (the Chinese Health Questionnaire [CHQ], Taiwanese Depression Questionnaire [TDQ]) and HRQoL (the 36-item Short Form Health Survey [SF-36]) at baseline and 1 month after radioactive iodine (RAI) therapy. Compared with the general Taiwanese population, patients with DTC reported a worse HRQoL in all dimensions of the SF-36. Multivariate regression models indicated that anxiety and depressive symptoms were inversely correlated with some dimensions (physical functioning, bodily pain, and general health perceptions for the CHQ; role limitations due to physical problems and social functioning for the TDQ). However, psychiatric follow-up and treatment history were significantly associated with physical functioning and role limitations owing to the physical problem dimensions of HRQoL. : In conclusion, although anxiety and depressive symptoms may negatively affect certain HRQoL domains, psychiatric follow-up can improve the physical dimensions.

摘要

尽管分化型甲状腺癌(DTC)患者预后良好,但其长期临床病程会影响他们的心理健康及健康相关生活质量(HRQoL)。然而,很少有研究评估影响该人群后续HRQoL的心理因素,尤其是在初始治疗阶段。

在这项为期1个月的队列研究中,我们评估了DTC患者的抑郁和焦虑症状以及HRQoL,并探究了HRQoL进一步受损的可能预测因素。

共有181例患者完成了问卷调查,他们在基线时以及放射性碘(RAI)治疗后1个月对自己的心理状态(中国健康问卷[CHQ]、台湾抑郁问卷[TDQ])和HRQoL(36项简明健康调查[SF - 36])进行了自评。与台湾普通人群相比,DTC患者在SF - 36的所有维度上报告的HRQoL更差。多变量回归模型表明,焦虑和抑郁症状与某些维度呈负相关(CHQ的身体功能、身体疼痛和总体健康感知;TDQ的因身体问题导致的角色限制和社会功能)。然而,精神科随访和治疗史与HRQoL的身体功能维度以及因身体问题导致的角色限制显著相关。

总之,尽管焦虑和抑郁症状可能对某些HRQoL领域产生负面影响,但精神科随访可以改善身体维度。

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