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首页> 外文期刊>Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer >Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting.
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Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting.

机译：姑息治疗环境中患有焦虑和抑郁的晚期癌症患者的症状困扰。

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BACKGROUND: Mood disorders are among the most distressing psychiatric conditions experienced by patients with advanced cancer; however, studies have not shown a direct association of physical symptoms with depression and anxiety. PURPOSE: The purpose of this study is to determine the relationship between the frequency and intensity of patients' physical symptoms and their expressions of depression and anxiety. PATIENTS AND METHODS: We retrospectively reviewed the records of 216 patients who had participated in three previous clinical trials conducted by our group. We assessed patients' demographic data using descriptive statistics. We analyzed physical symptom frequency and intensity using the Edmonton Symptom Assessment System (ESAS) and anxiety and depression using the respective subscales of the Hospital Anxiety and Depression Scale (HADS-A and HADS-D). RESULTS: Sixty-two percent were male; the median age was 59 years (range 20-91 years). Seventy nine (37%) of the patients had depressive mood (HADS-D > or = 8), and 94 (44%) had anxiety (HADS-A > or = 8). Patients with depressive mood expressed higher frequency of drowsiness (68/78, 64%; p = 0.0002), nausea (52/79, 66%; p = 0.0003), pain (74/79, 94%; p = 0.0101), dyspnea (68/79, 86%; p = 0.0196), worse appetite (72/79, 91%; p = 0.0051), and worse well-being (78/79, 99%; p = 0.0014) and expressed higher intensity of symptoms (ESAS > or = 1) [median (Q1-Q3)] including drowsiness [4 (3-7), p = 0.0174], fatigue [7 (5-8), p < 0.0001], and worse well-being [6 (5-7), p < 0.0001]. Patients with anxiety expressed higher frequency of nausea (59/94, 57%; p = 0.0006), pain (88/94, 89%; p = 0.0031), and dyspnea (84/94, 96%, p = 0.0002) and expressed a higher intensity of pain [6 (3-8), p = 0.0082], fatigue [6 (5-8), p = 0.0011], worse appetite [6 (4-8), p = 0.005], and worse well-being [5 (3-7), p = 0.0007]. Spearman's correlation showed a significant association between HADS-A and HADS-D and other symptoms in the ESAS. Spearman's correlations of HADS with ESAS-Anxiety and ESAS-Depression were 0.56 and 0.39, respectively (p < 0.001). CONCLUSION: Expression of physical symptoms may vary in frequency and intensity among advanced cancer patients with anxiety and depression. Patients expressing high frequency and intensity of physical symptoms should be screened for mood disorders in order to provide treatment for these conditions. More research is needed.
机译：背景：情绪障碍是晚期癌症患者最痛苦的精神疾病之一。然而，研究还没有表明身体症状与抑郁和焦虑有直接关系。目的：本研究的目的是确定患者身体症状的频率和强度与他们的抑郁和焦虑表达之间的关系。患者与方法：我们回顾性分析了216例患者的记录，这些患者参加了我们小组先前进行的三项临床试验。我们使用描述性统计数据评估了患者的人口统计数据。我们使用Edmonton症状评估系统（ESAS）分析了身体症状的频率和强度，并使用医院焦虑和抑郁量表的各个分量表（HADS-A和HADS-D）分析了焦虑和抑郁。结果：62％为男性;中位年龄为59岁（范围为20-91岁）。七十九名患者（37％）患有抑郁情绪（HADS-D>或= 8），而94名患者（44％）患有焦虑症（HADS-A>或= 8）。抑郁情绪患者的嗜睡发生率较高（68/78，64％; p = 0.0002），恶心（52/79，66％; p = 0.0003），疼痛（74/79，94％; p = 0.0101），呼吸困难（68/79，86％; p = 0.0196），食欲不振（72/79，91％; p = 0.0051），幸福感较差（78/79，99％; p = 0.0014），且强度更高症状（ESAS>或= 1）[中位数（Q1-Q3）]，包括嗜睡[4（3-7），p = 0.0174]，疲劳[7（5-8），p <0.0001]，且病情更糟-为[6（5-7），p <0.0001]。焦虑症患者出现较高的恶心频率（59/94，57％; p = 0.0006），疼痛（88/94，89％; p = 0.0031）和呼吸困难（84/94，96％，p = 0.0002）和表现出较高的疼痛强度[6（3-8），p = 0.0082]，疲劳[6（5-8），p = 0.0011]，食欲不佳[6（4-8），p = 0.005]，并且更糟幸福感[5（3-7），p = 0.0007]。 Spearman的相关性表明，HADS-A和HADS-D与ESAS中的其他症状之间存在显着关联。 HADS与ESAS焦虑和ESAS抑郁的Spearman相关性分别为0.56和0.39（p <0.001）。结论：患有焦虑和抑郁的晚期癌症患者的身体症状表达频率和强度可能有所不同。应对表现出高频率和高强度身体症状的患者进行筛查以检查其情绪障碍，以便为这些疾病提供治疗。需要更多的研究。

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