The Lancet Psychiatry：新疗法显著改善肿瘤患者抑郁症状

2014-09-01 马宏伟译医学论坛网

《柳叶刀·精神病学》The Lancet Psychiatry新近刊登的三篇文章显示，针对将近四分之三的肿瘤抑郁患者未接受抗抑郁治疗的现状，一项新的综合治疗方案比起当前的护理方式，在缓解抑郁症状、提高生活质量方面有着惊人的疗效。《柳叶刀·精神病学》The Lancet Psychiatry刊登的来自英国苏格兰癌症诊所纳入21，000例患者的数据分析发现，与普通人群相比，重度抑郁患者在患症患者人

《柳叶刀·精神病学》The Lancet Psychiatry新近刊登的三篇文章显示，针对将近四分之三的肿瘤抑郁患者未接受抗抑郁治疗的现状，一项新的综合治疗方案比起当前的护理方式，在缓解抑郁症状、提高生活质量方面有着惊人的疗效。

《柳叶刀·精神病学》The Lancet Psychiatry刊登的来自英国苏格兰癌症诊所纳入21，000例患者的数据分析发现，与普通人群相比，重度抑郁患者在患症患者人群中更为常见。重度抑郁的症状在肺癌患者人群中的发生率最高，可达13%。在泌尿肿瘤患者中的发生率最低，为6%。此外，将近四分之三(73%)的肿瘤患者未接受抗抑郁治疗。

为解决SMaRT 肿瘤-2 随机试验治疗不足的问题，评估新疗法有效性的项目，我们称之为“癌症患者的抑郁症状关怀”((DCPC))。该项目作为癌症护理的一部分，训练有素的癌症护士和精神科专家参与，他们与肿瘤医生和全科医师相互协作。这是一项系统的治疗方案，包括抗抑郁药物治疗和心理治疗。

这项试验纳入了500例重度抑郁且有着良好预后(生存期预期超过12个月)的肿瘤成人受试者，分别对他们进行DCPC和常规护理治疗。结果发现，DCPC能够显著缓解受试者的抑郁程度。在第六个月的时候，62%随机接受DCPC的受试者有了显著疗效，而常规护理的受试者仅有17%出现疗效。这一结果持续了12个月。DCPC也缓解了患者的焦虑、疼痛、无力、功能重建，并改善了总体的生活质量。此外，DCPC疗法的费用也是亮点，仅为613英镑。易于接受的价格减轻了患者的经济负担。

来自英国牛津大学的迈尔克·夏普教授认为，“DCPC疗法有着巨大的普及价值，它的显著疗效预示着我们即将可以像肿瘤科医生那样对肿瘤抑郁患者进行治疗。”

为了观察预后较差的肿瘤患者是否也能在本疗法中获益，SMaRT 肿瘤-3临床试验针对典型预后较差的肿瘤患者进行了接受DCPC治疗效果的测试。该测试纳入了142例肺癌伴重度抑郁的患者，通过32周的随访发现，比起接受常规护理的患者相比，接受DCPC治疗的癌症患者，其抑郁症状得到了明显改善。同时也改善了患者的焦虑问题，提高了生活质量。该结果已在《柳叶刀·肿瘤》杂志上发表。

根据英国牛津大学和Sobell House Hospice的研究作者珍妮·沃克教授的说法，“肺癌患者的预后通常较差，如果他们患有重度抑郁，会影响他们的生存期。本项研究的结论让这些患者充满希望。”

原始出处

Jane Walker， Christian Holm Hansen, Paul Martin MSc, Stefan Symeonides, Ravi Ramessur, Prof Gordon Murray, Prof Michael Sharpe.Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data.The Lancet Psychiatry,28 August 2014

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2014-09-11 howi

#Lancet#

48 0
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2015-03-29 diushouji

#Psychiatry#

47 0
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2014-09-03 lanyan20020087

#肿瘤患者#

61 0
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2014-09-03 zhouqu_8

#抑郁症状#

62 0
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2014-09-03 kcb074

#新疗法#

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