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甲状腺乳头状癌患者的焦虑和抑郁:一项纵向研究。

Anxiety and depression in papillary thyroid cancer patients: a longitudinal study.

作者信息

Zheng Yuenan, Zhao Jie, Shi Yang, Gui Zhiqiang, Xu Chun, Wu Qingshu, Wang Zhihong, Zhang Hao, He Liang

机构信息

Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning Province, PR China.

出版信息

Endocrine. 2025 Feb;87(2):675-684. doi: 10.1007/s12020-024-04035-4. Epub 2024 Oct 17.

Abstract

PURPOSE

Researches indicate that patients with papillary thyroid cancer (PTC) are prone to experiencing anxiety and depression. However, lacking of large-scale, prospective studies thoroughly examine the trajectory of these emotional states. Therefore, this study aims to investigate changes in anxiety and depression levels in PTC patients before and after operation and assess the impact of gender and menopausal states on emotional well-being.

METHOD

A prospective longitudinal study enrolled 320 PTC patients who completed the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) at pre- and post-operation. Paired-sample T-tests and logistic regression analysis were used to evaluate emotional changes and identify influencing factors.

RESULTS

Anxiety and depression levels significantly increased (p = 0.028, p = 0.005) postoperatively, with incidence of 13.8% for anxiety and 26.9% for depression. Multivariate regression analysis showed that gender was a factor affecting depression (p = 0.041), and menopausal state significantly influenced emotions including anxiety and depression (p = 0.004, p = 0.031). Subgroup analysis showed that female patients exhibited higher levels of adverse emotions postoperatively compared to preoperatively (p = 0.003, p < 0.001). Postoperatively, female patients were more susceptible to anxiety and depression (p = 0.011, p = 0.029), and postmenopausal women were particularly at risk for depression (p = 0.017).

CONCLUSIONS

The study highlights the importance of postoperative psychological care, particularly for female and postmenopausal patients. Larger sample sizes and longer follow-up periods are needed for a comprehensive understanding of psychological changes in PTC survivors.

摘要

目的

研究表明,甲状腺乳头状癌(PTC)患者容易出现焦虑和抑郁情绪。然而,缺乏大规模的前瞻性研究对这些情绪状态的轨迹进行全面考察。因此,本研究旨在调查PTC患者手术前后焦虑和抑郁水平的变化,并评估性别和绝经状态对情绪健康的影响。

方法

一项前瞻性纵向研究纳入了320例PTC患者,他们在手术前后完成了自评焦虑量表(SAS)和自评抑郁量表(SDS)。采用配对样本T检验和逻辑回归分析来评估情绪变化并确定影响因素。

结果

术后焦虑和抑郁水平显著升高(p = 0.028,p = 0.005),焦虑发生率为13.8%,抑郁发生率为26.9%。多因素回归分析表明,性别是影响抑郁的一个因素(p = 0.041),绝经状态显著影响包括焦虑和抑郁在内的情绪(p = 0.004,p = 0.031)。亚组分析显示,女性患者术后不良情绪水平高于术前(p = 0.003,p < 0.001)。术后,女性患者更容易出现焦虑和抑郁(p = 0.011,p = 0.029),绝经后女性尤其有抑郁风险(p = 0.017)。

结论

该研究强调了术后心理护理的重要性,特别是对于女性和绝经后患者。需要更大的样本量和更长的随访期来全面了解PTC幸存者的心理变化。

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