Nordin K, Glimelius B
Department of Oncology, University Hospital, Uppsala, Sweden.
Acta Oncol. 1997;36(8):803-10. doi: 10.3109/02841869709001361.
Reactions to diagnosis, coping strategies, and anxiety and depression were prospectively studied in 139 consecutive, newly diagnosed gastrointestinal cancer patients. The reactions varied between diagnoses (colon, rectum, gastric, pancreatic and biliary) and states of illness (cured non-cured). Colon and rectal cancer patients, most of whom were potentially cured, had a more confrontational attitude towards their diagnosis, reported more 'Fighting Spirit' and less 'Anxious Preoccupation' and 'Hopeless/Helplessness'. Non-cured patients reported higher levels of intrusive thoughts and avoidance of aversive thoughts than cured patients. The overall levels of anxiety and depression were low, although higher levels were seen for non-cured patients. On the Hospital Anxiety and Depression scale (HAD), a total of 17% were scored as 'doubtful cases' or 'cases' on the anxiety scale and 21% on the depression scale. Thus, pancreatic/biliary cancer patients, most of which are non-cured, and to some extent those with gastric cancer are more vulnerable to psychological distress in connection with the diagnosis than are colorectal cancer patients.
对139例连续新诊断的胃肠道癌症患者的诊断反应、应对策略以及焦虑和抑郁情况进行了前瞻性研究。这些反应因诊断类型（结肠癌、直肠癌、胃癌、胰腺癌和胆管癌）和疾病状态（治愈、未治愈）而异。结肠癌和直肠癌患者中大多数有可能治愈，他们对自己的诊断持更积极面对的态度，报告有更多的“斗志”，而“焦虑专注”和“绝望/无助”则较少。未治愈的患者比治愈的患者报告有更高水平的侵入性思维和对厌恶思维的回避。尽管未治愈患者的焦虑和抑郁总体水平较高，但焦虑和抑郁的总体水平较低。在医院焦虑抑郁量表（HAD）上，共有17%的患者在焦虑量表上被评为“可疑病例”或“病例”，在抑郁量表上为21%。因此，大多数无法治愈的胰腺癌/胆管癌患者以及在一定程度上的胃癌患者在诊断方面比结直肠癌患者更容易出现心理困扰。
