患有罕见癌症的患者的心理结果:系统性审查和元分析
Chen Ee Low1, Sean Loke1, Ga Eun Pang1
1Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore.
EClinicalMedicine
|May 10, 2024
概括
患有罕见癌症的患者面临更高的抑郁和焦虑风险. 这一审查强调了对这个脆弱人群的早期心理支持和干预的迫切需要.
科学领域:
- 在瘤学瘤学.
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 罕见的癌症,以低发病率定义 (每年每10万人中<6人),由于临床证据有限,存在独特的挑战.
- 与患有常见癌症患者相比,患有罕见癌症的患者经常经历更差的生存率和加剧的心理痛苦.
- 鉴于罕见癌症占所有癌症诊断的25%,了解它们的心理影响至关重要.
研究的目的:
- 在患有罕见癌症的患者中,系统地审查和综合有关心理结果的证据,包括抑郁,焦虑,自杀和PTSD.
- 为了比较这些心理结果在罕见癌症患者与健康对照和常见癌症患者的患病率和发病率.
主要方法:
- 2000年至2024年1月发表的研究的PRISMA-坚持的系统审查和元分析,搜索PubMed,Embase,Cochrane和PsycINFO.
- 包括32项研究,包括57,470名患有罕见癌症的患者.
- 随机效应元分析和元回归被用于数据合成和风险因素识别.
主要成果:
- 与健康对照组相比,患有罕见癌症的患者患抑郁症 (RR=2.61) 和焦虑症 (RR=2.66) 的风险显著增加.
- 抑郁症 (17%),焦虑症 (20%) 和创伤后应激障碍 (PTSD) (18%) 的患病率很高,自杀率很高 (每10万人/年有315人).
- 罕见癌症患者的自杀率和PTSD患病率明显高于常见癌症患者;晚期疾病,化疗和较低的社会经济地位被确定为危险因素.
结论:
- 罕见的癌症患者表现出不良心理结果的风险增加,包括抑郁症,焦虑症和PTSD.
- 这些发现强调了积极的心理查和针对被诊断患有罕见癌症的个体量身定制的干预策略的急需.
- 为了开发和评估有效的干预措施,以减轻这一群体的心理痛苦,进一步的研究是至关重要的.
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