新确诊癌症患者的焦虑、抑郁及失眠现状分析

Newly-diagnosed cancer patients’ anxiety, depression and insomnia symptoms and their relevant factors

目的【摘要】目的探究新确诊癌症患者群体的焦虑、抑郁及失眠现状及其影响因素。方法选取2018年1月至10月广东省人民医院肿瘤中心病房及门诊收治的新确诊癌症患者571例进行回顾性横断面调查研究,其中男性52例(9.1%),女性519例(90.9%);年龄21~88岁,平均(47.5±11.4)岁。分析患者的一般人口学、临床及社会心理学资料,通过抑郁症筛查量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)以及失眠症状筛查评价研究对象的焦虑、抑郁及失眠现状,采用多因素Logistic回归分析各影响因素与新确诊癌症患者出现焦虑、抑郁的相关性。结果在新确诊癌症患者中,焦虑症状检出率为28.2%(161/571),抑郁症状检出率为35.0%(200/571),失眠症状检出率为89.0%(508/571)。高龄(年龄>60岁,OR=2.387,95%CI:1.002~5.687)、无业(OR=1.860,95%CI:1.017~3.402)、独居(OR=16.012,95%CI:2.880~89.014)、共病(OR=0.573,95%CI:0.377~0.870)、高生活压力(OR=1.519,95%CI:1.192~1.936)和消极性格倾向(OR=6.005,95%CI:3.641~9.904)是新确诊癌症患者出现抑郁症状的危险因素。高生活压力(OR=1.802,95%CI;1.412~2.300)、消极性格倾向(OR=4.344,95%CI:2.699~6.992)和癌症家族史(OR=1.788,95%CI:1.137~2.812)是新确诊癌症患者出现焦虑症状的危险因素。结论新确诊的癌症患者处于特殊的身心应激状态,是焦虑、抑郁、失眠等心理问题的高发人群。应注意筛查患者的心理健康问题,及时做好心理干预,必要时加强心理及药物治疗。同时还应加强患者的家庭及社会支持,提高其心理弹性及应对能力,从而促进患者身心恢复,提高患者生活质量。

Objective To investigate cancer patient’s anxiety,depression and insomnia symptoms and their related influencing factors.Methods This was a retrospective cross-sectional study.A total of 571 newly-diagnosed cancer patients,with 52(9.1%)males and 519(90.9%)females(mean age:47.5±11.4,ranged from 21 to 88 years)were recruited from the Guangdong Provincial People’s Hospital.Participants were asked to complete the Patient Health Questionnaire(PHQ9),and the General Anxiety Disorder(GAD7),and a psychiatrist was involved to assess patient’s insomnia symptoms based on DSM-IV.Sociodemographic,clinical and psychosocial data were also collected.Multiple logistic regression analyses were conducted to examine the association between several factors and the prevalence of anxiety and depressive symptoms.Results The prevalence of anxiety and depression symptom of this sample were 28.2%,and 35.0%respectively,and the rate of sleep disturbance was 89.0%.Multiple logistic regression showed that older age(greater than 60 years,OR=2.387,95%CI:1.002~5.687),unemployment(OR=1.860,95%CI:1.017~3.402),physical comorbidity(OR=0.573,95%CI:0.377~0.870),higher life stress level(OR=1.519,95%CI:1.192-1.936),negative personality(OR=6.005,95%CI:3.641~9.904)and living alone(OR=16.012,95%CI:2.880-89.014)were significant independent factors for depressive symptom.Higher stress level(OR=1.802,95%CI:1.412~2.300),negative personality(OR=4.344,95%CI:2.699~6.992)and positive family cancer history(OR=1.788,95%CI:1.137~2.812)were significant influencing factors for anxiety symptom.Conclusions Anxiety,depression and insomnia symptoms in newly-diagnosed cancer patients are more commonly seen than that in the ordinary population.Health professionals should focus more attention on patient’s mental health while providing routine anti-oncology treatment.Increased family and social support are needed to help with the patient’s recovery as well as improving the individual’s quality of life.