不同阶段乳腺癌患者的抑郁、焦虑及影响因素

摘要

目的 调查乳腺癌各病程阶段抑郁和焦虑的发生情况及影响因素.方法 使用汉密尔顿抑郁量表(17项)和汉密尔顿焦虑量表对315例乳腺癌患者(包括术前组、术后组及康复组各105例)和105名正常对照者进行评估.结果 (1)患者组抑郁、焦虑得分(7.78±4.57、8.57±5.12)与对照组(3.07±2.42、3.89±3.10)比较,差异有统计学意义(P＜0.001)；患者发生抑郁、焦虑的比例(55.6％、59.7％)与对照组(8.6％、13.4％)比较,差异有统计学意义(P＜0.001).(2)病例组之间:术前组(6.22±3.81、7.17±4.29)与术后组(9.21±4.82、9.39±5.10),术前组与康复组(7.90±4.57、9.16±5.63)比较,得分差异均有统计意义(P＜0.001)；术后组和康复组得分差异无统计意义(P＞0.05).(3)Logistic回归分析显示低的领悟社会支持能力、失眠和伴有躯体疼痛和乳腺癌患者发生抑郁、焦虑相关.结论 乳腺癌患者抑郁、焦虑的发生率高于健康对照人群,其中术后组和康复组又高于术前组；抑郁、焦虑情绪会在乳腺癌临床痊愈后仍长期存在,无法自行缓解；领悟社会支持能力低、失眠、躯体疼痛是乳腺癌患者伴发抑郁和焦虑的危险因素.%Objective To investigate and explore the prevalence of depression and anxiety and their related factors among Chinese women with breast cancer of various stages.Methods A total of 315 breast cancer patients the same number of preoperative,postoperative and rehabilitation patients,and 105 healthy controls were recruited.Homemade population sociology questionnaire,the Hamilton depression scale(HAMD-17)and the Hamilton anxiety scale(HAMA) were used to assess.Results The scores of depression and anxiety in patients (7.78 ± 4.57、8.57 ± 5.12) were significantly higher than those in control group (3.07 ± 2.42、3.89 ± 3.10),There was significant difference between the preoperative and postoperative group,also between the preoperative and rehabilitation group,however no difference was found between postoperative and rehabilitation group.Logistic regression analysis showed that lower perceived social support,insomnia and bodily pain were associate with depression and anxiety.Conclusion The depression and anxiety in breast cancer were higher than healthy control group,and the postoperative and rehabilitation were higher than the preoperative group among patients.The severity of symptoms can not be alleviated in a long time.The risk factors of depression and anxiety were low scores in PSSS,insomnia and pain.