ANXIETY, DEPRESSION AND SUICIDE POSSIBILITY IN PATIENTS WITH LUNG, COLORECTAL AND HEAD-NECK CANCER

Öz

OBJECTIVE: Anxiety and depression are common psychiatric symptoms, and an increased risk of suicide is also seen in cancer patients. It was aimed to evaluate clinical features, anxiety and depression prevalence, and suicide probability in patients with lung, colorectal and head-neck cancer, also to compare these psychological factors with those with a healthy control group.
MATERIAL AND METHODS: The patients with 82 lung cancer, 99 colorectal cancer and 79 head-neck cancer and a control group of 98 healthy individuals were included in the study. Sociodemographic data form, Hospital Anxiety and Depression Scale (HADS) and Suicide Probability Scale (SPS) were administered to all the participants.
RESULTS: The prevalence of anxiety symptoms was 29.2% and depression was 52.7% in cancer patients. HADS anxiety and depression subscales and SPS mean scores were higher in cancer patients than healthy controls. The patients with head-neck cancer were more anxious, more depressed, and suicidal than the healthy controls. The patients with lung cancer were only more depressed than the healthy controls. Additionally, it was found that female gender, fatigue, and pain experience in cancer patients were seen as factors that increased the frequency of anxiety and depression; advanced stage disease was only related to the frequency of depression, and a history of psychiatric treatment affected only the frequency of anxiety.
CONCLUSIONS: Psychological factors varies in different types of cancer. The cancer patients should be evaluated in terms of psychiatric problems by the clinicians to determine the level of anxiety, depression, and suicidality.

Anahtar Kelimeler

• anxiety
• depression
• cancer
• psycho-oncology
• suicide

AKCİĞER, KOLOREKTAL VE BAŞ-BOYUN KANSERİ OLAN HASTALARDA ANKSİYETE, DEPRESYON VE İNTİHAR OLASILIĞI

Öz

AMAÇ: Anksiyete ve depresyon kanser hastalarında yaygın olan psikiyatrik belirtilerdir. Hem anksiyete bozuklukları ve depresyonda hem de kronik hastalıklarda intihar riski arttığından kanser hastalarında intihar olasılığının artacağı öngörülebilir. Bu çalışmada farklı kanser türleri ayrı ayrı ele alınarak akciğer, kolorektal ve baş-boyun kanserli hastalarda klinik özelliklerin, anksiyete ve depresyon prevalansının, intihar olasılığının değerlendirilmesi ayrıca bu psikolojik faktörlerin farklı kanser türlerinin birbiriyle ve sağlıklı kontrol grubu ile karşılaştırılması amaçlandı.
GEREÇ VE YÖNTEM: Kesitsel tasarımda planlanan bu çalışmaya onkoloji bölümünde yatarak veya ayaktan tedavi görmekte olan 82 akciğer, 99 kolorektal, 79 baş-boyun kanseri olan hasta grubu ve 98 sağlıklı bireyden oluşan kontrol grubu dahil edildi. Tüm katılımcılara psikiyatri doktoru tarafından sosyodemografik veri formu, hastalarda ağrı ve yorgunluk gibi klinik semptomları, kanser evresi ve psikiyatrik tedavi öyküsünü değerlendiren klinisyen tarafından oluşturulan bir anket formu, Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) ve İntihar Olasılığı Ölçeği (İOÖ) uygulandı.
BULGULAR: Kanser hastalarında anksiyete belirtileri prevalansının % 29.2, depresyon belirtileri prevalansının ise % 52.7 olduğu saptandı. HADÖ anksiyete ve depresyon alt ölçekleri ve İOÖ ortalama puanları kanser hastalarında sağlıklı kontrollerden istatistiksel açıdan anlamlı olarak daha yüksek saptandı. Baş-boyun kanserli hastaların depresyon, anksiyete ve intihar olasılığı düzeylerinin sağlıklı kontrollerden anlamlı olarak daha yüksek olduğu; akciğer kanserli hastaların sadece depresyon düzeylerinin sağlıklı kontrollerden anlamlı olarak daha yüksek olduğu görüldü. Ek olarak, kanser hastalarında kadın cinsiyet, yorgunluk ve ağrı deneyimlerinin anksiyete ve depresyon sıklığını artıran faktörler olduğu; ileri evre hastalığın yalnızca depresyon sıklığını, psikiyatrik tedavi öyküsünün de yalnızca anksiyete sıklığını etkilediği saptandı.
SONUÇ: Farklı kanser türlerinde anksiyete, depresyon ve intihar gibi psikolojik faktörler de değişkenlik göstermektedir. Farklı belirtiler farklı tedavi yöntemleri gerektireceğinden kanser hastalarında psikiyatrik belirtilerin de kanser tipine göre farklılık gösterebileceği akılda tutulmalıdır. Bu belirtilerden şüphelenildiğinde psikiyatri konsültasyonu ile sağlanacak tanı ve tedavi süreci hastaların kemoterapi veya radyoterapi sürecine uyumunu ve yaşam kalitelerini artıracaktır.

Anahtar Kelimeler

• anksiyete
• depresyon
• intihar
• kanser
• psikoonkoloji

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