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臺灣醫學

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篇名 癌症病人的憂鬱症
卷期 17:2
並列篇名 Depressive Disorders in Patients with Cancer
作者 莊永毓林青蓉楊翠雲靳燕芬王碧華
頁次 155-162
關鍵字 癌症憂鬱症心理治療抗憂鬱劑cancerdepressionpsychotherapyantidepressantTSCI
出刊日期 201303

中文摘要

憂鬱症在癌症病人是常見的,一般認為約有四分之一的癌症病人符合憂鬱症的診斷。但是在臨床上,癌症病人的憂鬱常被忽略,所以也未診斷及治療。研究顯示癌症病人的憂鬱症若是未治療,可能使其身體症狀更嚴重、日常體能狀態更差、也影響治療配合度與生活品質。因此運用量表定期篩檢癌症病人情緒,以早期發現需要協助的病人,提供心理腫瘤照護服務是重要的。現今已有許多量表運用於評估癌症病人的情緒壓力,如心理痛苦溫度計(Distress Thermometer),醫院焦慮憂鬱量表(Hospital Anxiety andDepression Scale)等,並有良好的信、效度。在治療上,不論心理治療或是抗憂鬱劑的使用,研究顯示具有療效,並能改善病人的情緒、痛苦症狀與生活品質。心理腫瘤服務的介入,當能減輕病人憂鬱情緒,及提高整體對癌症病人的醫療品質。未來的研究應針對個別的情緒或其他身心症狀,發展出特定的治療。

英文摘要

Depressive disorders in patients with cancers are common. About one fourth of all cancer patientssuffered from depression. Depression was often overlooked, undiagnosed and untreated among cancer patients inthe clinical settings. There were several instruments could provide screening for emotional distress of cancerpatients, such as Distress Thermometer and Hospital Anxiety and Depression Scale which revealed goodsensitivities and specificities. Unlike in the general populations, depression affected both men and women withcancers. Cancer patients with past history of depression, lack of social support, poorer functional status andsuffered from certain cancer-related symptoms were at higher risk to have depression. Treatment of depression incancer patients needs multidisciplinary intervention. Cancer patients with depression could benefit frompsychosocial intervention as well as pharmacotherapy. However, certain types of antidepressants might havenegative effect on patients with breast cancer treated on tamoxifen due to drug-drug interaction. The drug ofchoice should be considered according to individual patient’s condition. Further research is needed to establishthe relative and combined benefit of psychosocial and pharmacologic interventions. Future research directionsinclude the development and evaluation of novel interventions targeted to specific biologic and psychosocial riskfactors. This review article addresses the treatment of depression in cancer based on a consideration of evidenceregarding etiologic factors and treatment outcomes.

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