Depresija, anksioznost i kvalitet života kod bolesnika sa melanomom
Sažetak
Uvod/Cilj. Nedavna istraživanja pokazala su značajnu korelaciju između melanoma i kvaliteta života, kao i anksioznosti i depresije kod ovih bolesnika. U prognozi melanoma, najvažnija je faza u kojoj je dijagnostikovan. Cilj ove studije bila je analiza kvaliteta života, anksioznosti i depresije kod bolesnika sa dijagnozom melanoma u različitim stadijumima bolesti. Metode. U našoj studiji preseka su bili uključeni bolesnici dijagnostikovani i lečeni od melanoma (n = 40) na Klinici za kožne i polne bolesti Vojnomedicinske akademije u Beogradu od oktobra do decembra 2015. godine. Dvadeset bolesnika bilo je u I i II stadijumu (lokalizovana bolest), a preostalih 20 u IV fazi (udaljene metastaze). U istraživanju smo koristili Upitnik za procenu kvaliteta života obolelih od melanoma Evropskog udruženja za istraživanje i terapiju kancera (EORTC QLQ 30), Bekov upitnik o anksioznosti (BAI) i Bekov upitnik o depresiji (BDI). Statistička analiza uključila je parametarsku i neparametarsku opisnu statistiku. Rezultati. Kod bolesnika u I i II stadijumu bolesti anksioznost je bila veća u poređenju sa bolesnicima u IV stadijumu bolesti (37,5 naspram 14,5; p < 0,05), ali je depresija bila izraženija (6 naspram 2,5; p < 0,05) kod bolesnika u IV stadijumu. Nađene su statistički značajne razlike u svim segmentima kvaliteta života između bolesnika koji su bili u I i II stadijumu i bolesnika u IV stadijumu bolesti. Ukupan kvalitet života značajno je bio lošiji kod bolesnika u IV stadijumu (33,5 naspram 83), simptomatologija izraženija (78,5 naspram 0), a funkcionisanje značajno lošije (31 naspram 85) u odnosu na bolesnike u I i II stadijumu (p < 0.01) za sve segmente kvaliteta života. Zaključak. Anksioznost i kvalitet života opadaju, dok simptomi depresije rastu sa stadijumom napredovanja melanoma. Potreba za adekvatnom socijalnom i porodičnom podrškom, kao i psihološku pomoć neophodna je kod bolesnika sa melanomom, kako bi se što bolje podnela bolest. Dodatna istraživanja su potrebna za praćenje anksioznosti, depresije i kvaliteta života od trenutka dijagnoze bolesti tokom vremena, kao i uticaja novih modaliteta lečenja na sve ove parametre.
Reference
Tran AD, Fogarty G, Nowak AK, Espinoza D, Rowbotham N, Stockler MR, et al. A systematic review and meta-analysis of utility estimates in melanoma. Br J Dermatol 2018; 178(2): 384‒93.
Malkhasyan KA, Zakharia Y, Milhem M. Quality of life out-comes in patients with advanced melanoma: a review of the literature. Pigment Cell Melanoma Res 2017; 30(6): 511‒20.
Garbe C, Peris K, Hauschild A, Saiag P, Middleton M, Bastholt L, et al. European Dermatology Forum (EDF); European Asso-ciation of Dermato-Oncology (EADO); European Organisa-tion for Research and Treatment of Cancer (EORTC). Diag-nosis and treatment of melanoma. European consensus-based interdisciplinary guideline - Update 2016. Eur J Cancer 2016; 63: 201‒17.
Arnold M, Holterhues C, Hollestein LM, Coebergh JW, Nijsten T, Pukkala E, et al. Trends in incidence and prediction of cuta-neous melanoma across Europe up to 2015. J Eur Acad Der-matol Venereol 2014; 28(9): 1170‒8.
Rodríguez-Cerdeira C, Molares-Vila A, Carnero-Gregorio M, Cor-balán-Rivas A. Recent advances in melanoma research via "omics" platforms. J Proteomics 2018; 188: 152‒66.
Rat C, Hild S, Gaultier A, Khammari A, Bonnaud-Antignac A, Quereux G, et al. Anxiety, locus of control and sociodemo-graphic factors associated with adherence to an annual clinical skin monitoring: a cross sectional survey among 1000 high- risk French patients involvedin a pilot-targeted screening pro-gramme for melanoma. BMJ Open 2017; 7(10): e016071.
Hamama-Raz Y. Does psychological adjustment of melanoma survivors differs between genders? Psychooncology 2012; 21(3): 255–63.
Schuermeyer I, Maican A, Sharp R, Bena J, Triozzi PL, Singh AD. Depression, anxiety, and regret before and after testing to es-timate uveal melanoma prognosis. JAMA Ophthalmol 2016; 134(1): 51‒6.
Fischbeck S, Imruck BH, Blettner M, Weyer V, Binder H, Zeissig SR, et al. Psychosocial care needs of melanoma survivors: are they being met? PLoS One 2015; 10(8): e0132754.
Beutel ME, Fischbeck S, Binder H, Blettner M, Brähler E, Emrich K, et al. Depression, anxiety and quality of life in long-term survivors of malignant melanoma: a register-based cohort study. PLoS One 2015; 10(1): e0116440.
Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bot-tomley A. The EORTC QLQ-C30 scoring manual. 3rd ed. Bel-gium, Brussels: European Organization for Research and Treatment of Cancer; 2001.
Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56(6): 893‒7.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inven-tory for measuring depression. Arch. Gen. Psychiatry 1961; 4: 561–7.
Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory Twenty-five years of evalua-tion. Clin Psychol Rev 1988; 8(1): 77–100.
Pflugfelder A, Kochs C, Blum A, Capellaro M, Czeschik C, Detten-born T, et al. German Dermatological Society; Dermatologic Cooperative Oncology Group. Malignant melanoma S3-guideline "diagnosis, therapy and follow-up of melanoma". J Dtsch Dermatol Ges 2013; 11(Suppl 6): 1‒116, 1‒126. (Eng-lish, German)
Mayer S, Teufel M, Schaeffeler N, Keim U, Garbe C, Eigentler TK, et al. The need for psycho-oncological support for melanoma patients: Central role of patients' self-evaluation. Medicine (Baltimore) 2017; 96(37): e7987.
Bonnaud-Antignac A, Bourdon M, Dréno B, Quéreux G. Coping strategies at the time of diagnosis and quality of life 2 years later: a study in primary cutaneous melanoma patients. Cancer Nurs 2017; 40(1): E45‒E53.
Holterhues C, Cornish D, van de Poll-Franse LV, Krekels G, Koedijk F, Kuijpers D, et al. Impact of melanoma on patients’ lives among 562 survivors: a Dutch population-based study. Arch Dermatol 2011; 147(2): 177–85.
Hamama-Raz Y, Solomon Z, Schachter J, Azizi E. Objective and subjective stressors and the psychological adjustment of mela-noma survivors. Psychooncology 2007; 16(4): 287–94.
Mendis S, Davis S, Norrving B. Organizational update: the world health organization global status report on noncom-municable diseases 2014; one more landmark step in the com-bat against stroke and vascular disease. Stroke 2015; 46(5): e121‒2.
Albrecht K, Droll H, Giesler JM, Nashan D, Meiss F, Reuter K. Self-efficacy for coping with cancer in melanoma patients: its association with physical fatigue and depression. Psychooncol-ogy 2013; 22(9): 1972–8.
Vogel RI, Strayer LG, Ahmed RL, Blaes A, Lazovich D. A Qual-itative Study of Quality of Life Concerns following a Mela-noma Diagnosis. J Skin Cancer 2017; 2017: 2041872.
Dubravcić ID, Brozić JM, Aljinović A, Sindik J. Quality of life in Croatian metastatic melanoma patients. Coll Antropol 2014; 38(1): 69‒74.
Nowe E, Stöbel-Richter Y, Sender A, Leuteritz K, Friedrich M, Geue K. Review article: cancer-related fatigue in adolescents and young adults: a systematic review of the literature. Crit Rev Oncol Hematol 2017; 118: 63‒9.
Hinz A, Singer S, Brähler E. European reference values for the quality of life questionnaire EORTC QLQ-C30: Results of a German investigation and a summarizing analysis of six Euro-pean general population normative studies. Acta Oncol 2014; 53(7): 958–65.
Hamel JF, Pe M, Coens C, Martinelli F, Eggermont AM, Brand-berg Y, Bottomley A. A systematic review examining factors in-fluencing health related quality of life among melanomacancer survivors. Eur J Cancer 2016; 69: 189‒98.
Fischbeck S, Imruck BH, Blettner M, Weyer V, Binder H, Zeissig SR, at al. Psychosocial care needs of melanoma survivors: are they being met? PLoS One 2015; 10(8): e0132754.
Palesh O, Aldridge-Gerry A, Bugos K, Pickham D, Chen JJ, Greco R, et al. Health behaviors and needs of melanoma survivors. Support Care Cancer 2014; 22(11): 2973‒80.
Mehnert A, Koch U. Psychological comorbidity and health-related quality of life and its association with awareness, utili-zation, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. J Psycho-som Res 2008; 64(4): 383–91.
Tas F, Karabulut S, Guveli H, Kurul S, Erturk K, Guveli M, et al. Assessment of anxiety and depression status in Turkish cuta-neous melanoma patients. Asian Pac J Cancer Prev 2017; 18(2): 369‒73.
Tesio V, Ribero S, Castelli L, Bassino S, Leombruni P, Caliendo V, et al. Psychological characteristics of early-stage melanoma patients: a cross-sectional study on 204 patients. Melanoma Res 2017; 27(3): 277‒80.
Pereira MG, Ponte M, Ferreira G, Machado JC. Quality of life in patients with skin tumors: the mediator role of body image and social support. Psychooncology 2017; 26(6): 815‒21.