Plos Med:乳腺癌患者发生焦虑和抑郁的风险更高!

2021-02-25 MedSci原创 MedSci原创

根据2020年12月国际癌症研究机构(IARC)发布的数据,乳腺癌已超肺癌成世界上最常见的癌症。然而,患乳腺癌的女性可能会经历治疗带来一系列的生活困扰,比如对癌症复发的担忧、择业或经济困难,而且对心理

根据202012月国际癌症研究机构(IARC)发布的数据,乳腺癌已超肺癌成世界上最常见的癌症。然而,患乳腺癌的女性可能会经历治疗带来一系列的生活困扰,比如对癌症复发的担忧、择业或经济困难,而且对心理健康有着严重的负面影响。然而,大规模的研究中几乎没有证据可以量化癌症史对人们长期心理健康的影响。

近日,发表在Plos Med杂志的一项研究显示,与没有癌症的女性相比,乳腺癌幸存者存在发生焦虑,抑郁,睡眠,性功能障碍,疲劳以及疼痛等风险更高。在确诊后的2年和4年中,乳腺癌患者焦虑和抑郁的发生率显著增加,而疲劳,疼痛和睡眠障碍在诊断5-10年升高。

在这项研究中,通过英国各地初级保健中常规收集的数据进行了一项匹配的队列研究,以量化乳腺癌史与抑郁、焦虑和其他心理健康相关结果之间的关联。研究人员收纳了来自1988年至2018年期间,临床实践研究数据库(CPRD)中57571名乳腺癌女性,平均年龄为62岁,然后根据年龄、初级保健实践和数据与医院数据源链接的资格,与先前没有癌症的230067名女性进行1:4匹配。通过Cox对乳腺癌存活率与不同心理健康相关结果进行评估。

结果发现,乳腺癌存活率与焦虑(调整后的危险比(HR=1.3395%置信区间(CI):1.29-1.36P <0.001)、抑郁(1.351.32-1. 38p <0.001)、性功能障碍(1.271.17-1.38p <0.001)和睡眠障碍(1.681.63-1.73p <0.001)呈正相关,但与认知功能障碍(1.000.97-1.04p = 0.88)并无显著关系。疲劳(HR=1.281.25-1.31p0.001)、疼痛(1.221.20-1.24p0.001)、接受阿片类镇痛药(1.861.83-1.90p0.001)和致命性和非致命性自我伤害(1.150.97-1.36p=0.11)也存在正相关,但CI较宽,且后者的关系无统计学意义。

值得注意的是,焦虑和抑郁的HR随时间推移而降低,但在癌症诊断后2年到4年,焦虑和抑郁的风险增加。疼痛和睡眠障碍在诊断后5-10年有所提高。乳腺癌患者年龄越小,抑郁症,认知功能障碍,疼痛,使用阿片类镇痛药和睡眠障碍的HR越高。

综上,乳腺癌患者与多种不良心理健康有关。在诊断前/后以及治疗过程中,不良心理健康风险显著增加。因此,对乳腺癌患者进行早期诊断和管理可能会减轻疾病所损在的长期健康风险。

原始出处

Helena Carreira ,Rachael Williams,Garth Funston,Susannah Stanway,Krishnan Bhaskaran.Associations between breast cancer survivorship and adverse mental health outcomes: A matched population-based cohort study in the United Kingdom.Plos Med.2021. https://doi.org/10.1371/journal.pmed.1003504

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    2021-04-07 ms6000001015893838

    已看,还可以。

    0

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    2021-02-27 ms4000001548147119

    学习了

    0

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  5. [GetPortalCommentsPageByObjectIdResponse(id=954943, encodeId=8f8a954943a5, content=已看,还可以。, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bc65476534, createdName=ms6000001015893838, createdTime=Wed Apr 07 16:22:36 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=943887, encodeId=f45694388eac, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59e65457043, createdName=ms4000001548147119, createdTime=Sat Feb 27 08:07:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571240, encodeId=027315e124013, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Sat Feb 27 06:19:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610926, encodeId=e0551610926bc, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat Feb 27 06:19:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=927278, encodeId=aef392e278bc, content=好好学习,拓展思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/12/05/9151d1e89e73add788e7d96c55fb5dec.jpg, createdBy=dcfd2497546, createdName=124902dfm95暂无昵称, createdTime=Fri Feb 26 06:47:01 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050543, encodeId=c60e105054320, content=焦虑是当年年轻人的共同问题,需要认真对待。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Thu Feb 25 18:19:52 CST 2021, time=2021-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=927130, encodeId=b1fa92e13061, content=好文章!一, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 25 15:44:25 CST 2021, time=2021-02-25, status=1, ipAttribution=)]
    2021-02-26 124902dfm95暂无昵称

    好好学习,拓展思路

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=954943, encodeId=8f8a954943a5, content=已看,还可以。, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bc65476534, createdName=ms6000001015893838, createdTime=Wed Apr 07 16:22:36 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=943887, encodeId=f45694388eac, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59e65457043, createdName=ms4000001548147119, createdTime=Sat Feb 27 08:07:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571240, encodeId=027315e124013, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Sat Feb 27 06:19:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610926, encodeId=e0551610926bc, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat Feb 27 06:19:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=927278, encodeId=aef392e278bc, content=好好学习,拓展思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/12/05/9151d1e89e73add788e7d96c55fb5dec.jpg, createdBy=dcfd2497546, createdName=124902dfm95暂无昵称, createdTime=Fri Feb 26 06:47:01 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050543, encodeId=c60e105054320, content=焦虑是当年年轻人的共同问题,需要认真对待。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Thu Feb 25 18:19:52 CST 2021, time=2021-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=927130, encodeId=b1fa92e13061, content=好文章!一, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 25 15:44:25 CST 2021, time=2021-02-25, status=1, ipAttribution=)]
    2021-02-25 明天jing

    焦虑是当年年轻人的共同问题,需要认真对待。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=954943, encodeId=8f8a954943a5, content=已看,还可以。, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bc65476534, createdName=ms6000001015893838, createdTime=Wed Apr 07 16:22:36 CST 2021, time=2021-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=943887, encodeId=f45694388eac, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59e65457043, createdName=ms4000001548147119, createdTime=Sat Feb 27 08:07:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571240, encodeId=027315e124013, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Sat Feb 27 06:19:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610926, encodeId=e0551610926bc, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat Feb 27 06:19:52 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=927278, encodeId=aef392e278bc, content=好好学习,拓展思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/12/05/9151d1e89e73add788e7d96c55fb5dec.jpg, createdBy=dcfd2497546, createdName=124902dfm95暂无昵称, createdTime=Fri Feb 26 06:47:01 CST 2021, time=2021-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050543, encodeId=c60e105054320, content=焦虑是当年年轻人的共同问题,需要认真对待。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=明天jing, createdTime=Thu Feb 25 18:19:52 CST 2021, time=2021-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=927130, encodeId=b1fa92e13061, content=好文章!一, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Thu Feb 25 15:44:25 CST 2021, time=2021-02-25, status=1, ipAttribution=)]
    2021-02-25 jyzxjiangqin

    好文章!一

    0

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