老年进展期癌症患者自杀意念及危险因素多中心调查  

A multi-center study of detection rate and risk factors of suicidal ideation in old adults with advanced cancer

作　　者：汪艳[1] 庞英[1] 何毅[1] 王玉[2] 陆永奎[3] 姜愚 宋丽华 王丽萍[6] 李梓萌[1] 吕晓君 姚俊涛 刘晓红[9] 周晓艺[10] 何双智 张叶宁[1] 宋丽莉[1] 王冰梅[1] 苏中格 唐丽丽[1] WANG Yan;PANG Ying;HE Yi;WANG Yu;LU Yongkui;JIANG Yu;SONG Lihua;WANG Liping;LI Zimeng;LYU Xiaojun;YAO Juntao;LIU Xiaohong;ZHOU Xiaoyi;HE Shuangzhi;ZHANG Yening;SONG Lili;WANG Bingmei;SU Zhongge;TANG Lili(Key laboratory of Carcinogenesis and Translational Research(Ministry of Education/Bejing),Department of Psycho oncology,Peking University Cancer Hospital&Instiute,Bejing 100142,China;Department of Breast Cancer Radiotherapy,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China;The Fifth Department of Chemotherapy,the Affiliated Cancer Hospital of Guangxi Medical University,Nanning 530021,China;Department of Medical Oncology,Cancer Center,West China Hospital,Sichuan University,Chengdu 610000,China;Department of Breast Cancer Intemal Medicine,Shandong Cancer Hospital and Istitute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China;Department of Oncology,the First Affliated Hospital of Zheng zhou University,Zhengzhou 450052,China;Departent of Oncology,Xiamen Humanity Hospital,Xiamen 361016,Fujian Province,China;Department of Integrated Chinese and Western Medicine,Shaanxi Cancer Hospital Affiliated to Medical College of Xi'an Jiaotong University,Xi'an 710061,China;Hunan Cancer Hospital/the Affliated Cancer Hospital of Xiangya School of Medicine,Central South University,Changsha 410006,China;Radiotherapy Center,Hubei Cancer Hospital,Wuhan 430079,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所,康复科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]山西省肿瘤医院放疗中心乳腺放疗科,太原030013 [3]广西医科大学附属肿瘤医院乳腺及软组织肿瘤内科,南宁530021 [4]四川大学华西临床医学院四川大学华西医院肿瘤中心,成都610000 [5]山东第一医科大学(山东省医学科学院),山东省肿瘤防治研究院(山东省肿瘤医院)乳腺内科,济南250117 [6]郑州大学第一附属医院肿瘤科,郑州450052 [7]厦门弘爱医院肿瘤内科,福建厦门361016 [8]西安交通大学医学院附属陕西省肿瘤医院中西医结合科,西安710061 [9]湖南省肿瘤医院,长沙410006 [10]湖北省肿瘤医院放疗科,武汉430079

出　　处：《中国心理卫生杂志》2023年第11期938-944,共7页Chinese Mental Health Journal

基　　金：中国中医科学院科技创新工程项目(CI2021A01819)。

摘　　要：目的:了解老年进展期癌症患者自杀意念的检出率及危险因素。方法:采用横断面研究设计,使用病人健康问卷-9、MD安德森症状问卷、医院焦虑抑郁量表(HADS)对全国10个中心的住院进展期癌症患者进行调查,样本为年龄65岁及以上的691例老年患者,使用logistic回归分析从人口统计学与疾病相关因素、症状负担和心理痛苦3个层面探索自杀意念的危险因素。结果:老年进展期癌症患者自杀意念的检出率为21.7%。焦虑(HADS-A得分≥8:OR=4.48,95%CI:2.60~7.71,P<0.001)、抑郁(HADS-D得分≥8:OR=2.50,95%CI:1.46~4.27,P<0.01)是自杀意念的危险因素。结论:焦虑、抑郁是老年进展期癌症患者自杀意念突出的危险因素,应重视对这一人群的焦虑抑郁的筛查。Objective:To investigate the detection rate of suicidal ideation in old adults with advanced cancer and to explore the risk factors related to suicidal ideation.Methods:A cross-sectional study was conducted.The patients with advanced cancer in 10 centers over China were surveyed with the Patient Health Questionnaire-9(PHQ-9),MD Anderson Symptom Inventory(MDASD),and Hospital Anxiety and Depression Scale(HADS).There were 691 patients aged≥65 years old were selected as the target sample analyzed in this study.Logistic regression was used to explore the risk factors of suicidal ideation from demographic and disease related factors,symptom burden and psychological distress.Results:The detection rateof suicidal ideation was 21.7%in this sample.Anxiety(HADS-A≥8,OR=4.48,95%CI:2.60-7.71,P<0.001)and depression(HADS-D≥8,OR=2.50,95%CI:1.46-4.27,P<0.01)was the risk factor of suicidal ideation.Conclusion:It suggests that anxiety and depression may be the prominent risk factor of suicidal ideation in old patients with advanced cancer and it is necessary to pay attention to the screening of anxiety and depression in this population.

关 键 词：老年 进展期癌症 自杀意念 危险因素 心理痛苦 多中心 

分 类 号：R730.9[医药卫生—肿瘤] C913.9[医药卫生—临床医学]