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

Yıl 2021, , 21 - 28, 05.01.2021

Başak Özyıldırım Koç Özkan Güler Bengü Yücens

https://doi.org/10.18229/kocatepetip.635237

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

Kaynakça

• Ulutin HC. Psycologic problems in the cancer patient. Turkish Journal of Physical Medicine and Rehabilitation 2006; 9 (1): 39-41.
• Roy-Byrne PP, Davidson KW, Kessler RC, Asmundson GJG, Goodwin RD, et al. Anxiety disorders and comorbid medical illness. General Hospital Psychiatry 2008; 30 (3): 208–25.
• Seven M, Akyuz A, Sever N, Dincer S. Studying the Physical and Psychological Symptoms of Patients With Cancer. TAF Preventive Medicine Bulletin 2013; 12 (3): 219
• Nelson CJ, Cho C, Berk AR, Holland J, Roth AJ. Are gold standard depression measures appropriate for use in geriatric cancer patients? A systematic evaluation of self-report depression instruments used with geriatric, cancer, and geriatric cancer samples. Journal of Clinical Oncology 2010; 28 (2): 348–56.
• Siegel RL, Miller KD, Jemal A. Cancer statistics. CA: A Cancer Journal for Clinicians 2019; 69 (1): 7–34.
• Atesci FC, Oguzhanoglu NK, Baltalarli B, Karadag F, Ozdel O, Karagoz N. Psychiatric disorders in cancer patients and associated factors. Turkish Journal of Psychiatry 2003; 14 (2): 145–52.
• Massie MJ. Prevalence of Depression in Patients With Cancer. Journal of the National Cancer Institute Monographs 2004; (32): 57–71.
• Polidoro Lima M, Osório FL. Indicators of psychiatric disorders in different oncology specialties: a prevalence study. Journal of Oncology 2014; 350262.
• Diaz-Frutos D, Baca-Garcia E, Mahillo-Fernandez I, Garcia-Foncillas J, Lopez-Castroman J. Suicide ideation among oncologic patients in a Spanish ward. Psychology & Health &Medicine 2016; 21 (3): 261–71.
• Yousaf U, Christensen M-L, Engholm G, Storm HH. Suicides among Danish cancer patients 1971-1999. British Journal of Cancer 2005; 92 (6): 995–1000.
• Dormer NRC, McCaul KA, Kristjanson LJ. Risk of suicide in cancer patients in Western Australia, 1981–2002. The Medical Journal of Australia 2008; 188 (3): 140–3.
• Tsirigotis K, Gruszczynski W, Tsirigotis M. Gender differentiation in methods of suicide attempts. Medical Science Monitor 2011; 17 (8): PH65-70.
• Misono S, Weiss NS, Fann JR, Redman M, Yueh B. Incidence of Suicide in Persons With Cancer. Journal of Clinical Oncology 2008; 26 (29): 4731–8.
• Aydemir O, Guvenir T, Kuey L, Kultur S. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry 1997; 8 (4): 280–7.
• Atli Z, Eskin M, Dereboy C. The Validity and the Reliliability of Suicide Probability Scale (SPS) in Clinical Sample. J Clin Psy. 2009;(12):111–24.
• Delgado-Guay M, Parsons HA, Li Z, Palmer JL, Bruera E. Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Support Care Cancer. 2009; 17 (5): 573–9.
• Linden W, Vodermaier A, MacKenzie R, Greig D. Anxiety and depression after cancer diagnosis: Prevalence rates by cancer type, gender, and age. Journal of Affective Disorders 2012; 141 (2–3): 343–51.
• Wilson KG, Chochinov HM, Graham Skirko M, Allard P, Chary S, et al. Depression and Anxiety Disorders in Palliative Cancer Care. Journal of Pain and Symptom Management 2007; 33 (2): 118–29.
• Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. Anxiety and depression in Iranian breast cancer patients before and after diagnosis. European Journal of Cancer Care 2000; 9 (3): 151–7.
• Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L. Assessment of Anxiety and Depression in Advanced Cancer Patients and their Relationship with Quality of Life. Quality of Life Research 2005; 14 (8): 1825–33.
• Esme H, Sezer M, Güler O. Akciğer Kanserli Hastalarda Tanıyı Bilme ile Anksiyete Düzeyi Arasindaki İlişki. Solunum. 2006; 8 (4): 163-7.
• Tavoli A, Mohagheghi MA, Montazeri A, Roshan R, Tavoli Z, Omidvari S. Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter? BMC Gastroenterology 2007; 7 (1): 28.
• Özer H, Çayköylü A, Kırpınar I. Kanserli hastalarda tanıyı bilmenin depresif belirtilere etkisi. Atatürk Üniversitesi Tıp Dergisi 1997; 29(3): 491-4.
• Theobald DE. Cancer pain, fatigue, distress, and insomnia in cancer patients. Clinical Cornerstone 2004; 6 Suppl 1: 15-21.
• Brown LF, Kroenke K. Cancer-related fatigue and its associations with depression and anxiety: a systematic review. Psychosomatics. 2009; 50 (5): 440–7.
• Romito F, Montanaro R, Corvasce C, Di Bisceglie M, Mattioli V. Is cancer-related fatigue more strongly correlated to haematological or to psychological factors in cancer patients? Supportive Care in Cancer. 2008; 16 (8): 943–6.
• Yalvaç HD, Şahiner İV. Kanserde Yorgunluk ve Ağrı. Türkiye Klinikleri Psikiyatri - Özel Konular 2014; 7 (4): 39–43.
• Maunsell E, Brisson J, Deschênes L. Psychological distress after initial treatment of breast cancer. Assessment of potential risk factors. Cancer 1992; 70 (1): 120–5.
• Duffy SA, Ronis DL, Valenstein M, Fowler KE, Lambert MT, Bishop C, et al. Depressive Symptoms, Smoking, Drinking, and Quality of Life Among Head and Neck Cancer Patients. Psychosomatics 2007; 48 (2): 142–8.
• Lang H, France E, Williams B, Humphris G, Wells M. The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psycho-oncology 2013; 22 (12): 2648–63.
• Katz MR, Irish JC, Devins GM, Rodin GM, Gullane PJ. Psychosocial adjustment in head and neck cancer: The impact of disfigurement, gender and social support. Head & Neck 2003; 25 (2): 103–12.
• Van Cann EM, Dom M, Koole R, Merkx MAW, Stoelinga PJW. Health related quality of life after mandibular resection for oral and oropharyngeal squamous cell carcinoma. Oral Oncology 2005; 41 (7): 687–93.
• Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psycho-oncology 2001; 10 (1): 19–28.
• Simmons KL, Smith JA, Bobb K-A, Liles LLM. Adjustment to colostomy: stoma acceptance, stoma care self-efficacy and interpersonal relationships. Journal of Advanced Nursing 2007; 60 (6): 627–35.
• Karadag A, Mentes BB, Uner A, Irkorucu O, Ayaz S, et al. Impact of stomatherapy on quality of life in patients with permanent colostomies or ileostomies. International Journal of Colorectal Disease 2003; 18 (3): 234–8.
• Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR. Mixed Anxiety/Depression Symptoms in a Large Cancer Cohort: Prevalence by Cancer Type. Psychosomatics 2009; 50 (4): 383–91.
• Ell K, Sanchez K, Vourlekis B, Lee P-J, Dwight-Johnson M, Lagomasino I, et al. Depression, Correlates of Depression, and Receipt of Depression Care Among Low-Income Women With Breast or Gynecologic Cancer. Journal of Clinical Oncology 2005; 23 (13): 3052–60.
• Kim YJ, Lee KJ. Relationship of Social Support and Meaning of Life to Suicidal Thoughts in Cancer Patients. Journal of Korean Academy of Nursing 2010; 40 (4): 524.
• Anguiano L, Mayer DK, Piven ML, Rosenstein D. A Literature Review of Suicide in Cancer Patients. Cancer Nursing 2012; 35 (4): E14–26.