心理反应对乳腺癌存活率的影响:基于人口的队列研究
M Watson1, J S Haviland, S Greer
1Royal Marsden Hospital NHS Trust, Sutton, Surrey, UK. maggie.watson@rmh.nthames.nhs.uk
Lancet (London, England)
|October 26, 1999
概括
无助感和抑郁症等心理因素会对乳腺癌的存活率产生负面影响. 一个高的无助/绝望得分适度地损害了生存率,而抑郁症显著降低了生存率,尽管这一发现需要谨慎.
科学领域:
- 心理瘤学 心理瘤学
- 癌症生存率研究的研究.
- 临床心理学 临床心理学
背景情况:
- 对乳腺癌的心理反应,包括无助感和战斗精神,是潜在的预后因素.
- 在早期乳腺癌中,心理反应对疾病结果的影响需要进一步研究.
研究的目的:
- 为了研究心理反应对疾病结局的影响,在一大群患有早期乳腺癌的妇女中.
主要方法:
- 在578名患有早期乳腺癌的女性中进行了前性生存研究.
- 使用心理调整癌症 (MAC),柯塔尔德情绪控制 (CEC) 和医院焦虑和抑郁 (HAD) 尺度评估的心理反应.
- 随访至少5年,以考克斯的比例危险回归分析进行临床因素调整.
主要成果:
- 在HAD尺度的抑郁症类别上得分高,死亡风险显著增加5年 (HR3.59).
- 在MAC尺度的无助/绝望类别上的高分数显著增加了5年的复发或死亡风险 (HR 1.55).
- 在"战斗精神"和生存结果之间没有发现显著的关联.
结论:
- 高无助/绝望得分对无事件的5年生存期有中等的有害影响.
- 高抑郁症得分与生存率显著降低有关,尽管这需要谨慎解释,因为患者的子集很小.
- 心理健康是乳腺癌预后的一个关键因素.
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