Peutz-Jeghers综合征患者癌症担忧及相关心理健康问题的分析  

Analysis of cancer worry and related mental health problems in patients with Peutz-Jeghers syndrome

作　　者：王志青[1] 侯艳飞 谷艺修[1] 陈静[1] 陈新奇 冯洁 吴保平[1] WANG Zhi-qingl;HOU Yan-fei;GU Yi-xiul;CHEN Jingl;CHEN Xin-qil;FENG Jiel;WU Bao-pingl(Department of Gastroenterology,Nanfang Hospital,Southern Medical University,Guangzhou 510515;Department of Psychology,Public Healthy School,Southern Medical University,Guangzhou 510515)

机构地区：[1]南方医科大学南方医院消化内科,510515 [2]南方医科大学公共卫生学院心理系,510515

出　　处：《现代消化及介入诊疗》2018年第2期160-164,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学基金(81401925);广东省自然科学基金(2015A030310102)

摘　　要：目的了解Peutz-Jehgers综合征(PJS)患者癌症担忧状况及与精神症状、生活满意度的关系。方法采用人口学资料和临床资料问卷、癌症担忧量表、抑郁-焦虑-压力反应量表和生活满意度量表,对127例PJS患者进行调查。结果 86.3%的患者在20岁之前出现临床症状,>6次内镜检查的患者达40.2%,75.6%的患者经历至少一次外科剖腹手术,31例(24.4%)患者有癌症家族史,发生恶性肿瘤年龄为(43.97±11.55)岁(19~71岁)。患者癌症担忧平均得分为(17.83±5.84)分,分级为较严重癌症担忧;不同人口学和临床特征患者的癌症担忧得分为16.15~19.33分,癌症担忧程度均为较严重水平,得分变化幅度小,差异均无统计学意义(P>0.05)。患者抑郁、焦虑、压力反应和生活满意度得分分别为(14.34±11.30)分、(12.64±8.85)分、(16.07±9.94)分和(14.41±6.80)分,表明被试存在中度抑郁和焦虑、轻度压力反应、对生活不满意。癌症担忧水平越高,抑郁、焦虑、压力反应越严重,生活满意度越低。癌症担忧可直接影响抑郁-焦虑-压力反应,也可通过影响生活满意度间接影响抑郁-焦虑-压力反应。结论本研究首次报道我国PJS患者表现出较严重癌症担忧,并伴随中度抑郁焦虑、轻度压力反应及低生活满意度,癌症担忧是患者的核心问题。Objective To investigate the cancer worry and its relationship with psychiatric symptoms and life satisfaction in patients with Peutz-Jeghers syndrome. Methods A total of 127 patients with PJS were investigated by using demographic data and clinical data, Depression Anxiety Stress Scale-21, Satisfaction with Life Scale and Cancer worry scale. Results In this study, 86.3% of the patients manifested clinical symptoms before the age of 20, 40.2% of the patients experienced more than 6 endoscopic examination, 75.6% of the patients experienced at least once laparotomy, 31 cases（24.4%） had cancer family history, the average age of cancer was（43.97 ± 11.55） years old（19 ~ 71 years old）. The average score of Cancer worry scale was 17.83 ±5.84, which was classified as serious cancer worries. The scores in patients with different demographic and clinical characteristics was during 16.15 ~ 19.33, also classified as serious cancer worries; the variation was small, and the difference was not statistically significant（P〉 0.05）. The scores of patients with depression,anxiety, stress and life satisfaction were 14.34 ± 11.30, 12.64 ± 8.85, 16.07 ± 9.94, and 14.41 ± 6.80 respectively, classified as moderate depression, moderate anxiety, slight stress and lower life satisfaction. The higher the level of cancer worries, the more serious the depression, anxiety, and stress, and the lower life satisfaction.Cancer worries could directly affect depression-anxiety-stress, or indirectly affect depression-anxiety-stress by influencing life satisfaction. Conclusion This study first reported that PJS patients showed serious cancer worries, moderate depression and anxiety, slight stress and lower life satisfaction. It indicated that the cancer worry was the main problem of PJS patients.

关 键 词：PEUTZ-JEGHERS综合征 癌症担忧 抑郁焦虑压力 生活满意度 

分 类 号：R596.1[医药卫生—内科学]