首诊鼻咽癌患者焦虑抑郁现状及其与恐惧疾病进展的关系

Current status of depression and anxiety in newly diagnosed nasopharyngeal carcinoma patients and their relationship with fear of disease progression

目的分析首诊鼻咽癌患者抑郁、焦虑等心理问题的现况及其与恐惧疾病进展的关系。方法选择我院放疗科2023年3月—2024年4月就诊的鼻咽癌患者中存在中度及以上抑郁症状的患者作为研究对象,采用一般情况调查表、抑郁焦虑量表、恐惧疾病进展量表及社会支持量表进行调查,采用多因素Logistic回归分析恐惧疾病进展水平与抑郁、焦虑的相关关系。结果本研究共调查90例患者,中度及以上焦虑的比例为54%,同时存在中重度抑郁和中重度焦虑的患者比例为14%。恐惧疾病进展与焦虑(r=0.381,P<0.001)、抑郁(r=0.587,P<0.001)呈正相关(P<0.001)。恐惧疾病进展高水平组的中重度抑郁、中重度焦虑的比例均显著高于低水平组(P<0.001)。校正多因素的分析显示,相对于恐惧疾病进展低水平组,高水平组患者发生中重度及以上焦虑的风险增加16.34倍(95%CI:2.57~103.93,P=0.003)、中重度以上抑郁和焦虑共患病的风险增加6.9倍(95%CI:1.34~35.60;P=0.021)。结论抑郁和焦虑存在显著的共患病情况。相对于恐惧疾病进展的低水平组,高水平组患者发生焦虑以及同时出现抑郁和焦虑的风险显著增加。

Objective To analyze the current status of psychological problems including depression,anxiety,etc.,in newly diagnosed nasopharyngeal carcinoma patients and their relationship with fear of disease progression.Methods Patients with nasopharyngeal carcinoma who were treated in Department of Radiotherapy in our hospital from March 2023 to April 2024 and had moderate or severe depressive symptoms were selected as research subjects.They were surveyed using the General Information Questionnaire,Depression and Anxiety Scale,Fear of Disease Progression Scale and Social Support Scale.Multivariate logistic regression analysis was used to analyze the relationship between fear of disease progression level and depression and anxiety.Results Ninety patients were investigated.The proportion of patients with moderate or severe anxiety was 54%.The proportion of patients with comorbid moderate or severe depression and anxiety was 14%.Fear of disease progression was positively correlated with anxiety(r=0.381,P<0.001)and depression(r=0.587,P<0.001,P<0.001).The proportion of moderate or severe depression and anxiety in the high fear of disease progression group was significantly higher than that in the low group(P<0.001).After adjusting for multiple factors,the risk of moderate or severe anxiety in the high fear of disease progression group increased 16.34 times(95%CI:2.57~103.93,P=0.003)when compared with that in the low group,and the risk of comorbid moderate or severe depression and anxiety increased 6.9 times(95%CI:1.34~35.60;P=0.021).Conclusion There is a significant comorbidity of depression and anxiety.Compared with that in the low fear of disease progression group,the risk of anxiety and comorbid depression and anxiety increases significantly in the high group.