Psychosocial aspects after disclosure of genetic test results regarding hereditary cancer and construction of cancer genetic counseling system

遗传性癌症基因检测结果公开后的心理问题及癌症遗传咨询体系的构建

基本信息

批准号：
14370139
负责人：
OKAMURA Hitoshi
金额：
$ 5.95万
依托单位：
HIROSHIMA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2004
项目状态：
已结题

项目摘要

Purpose : The objectives of this study were to identify the prevalence and predictors of psychological impacts one month and one year after disclosure of the test results in Japanese probands and unaffected relatives.Methods : Probands and unaffected relatives were interviewed immediately after the first genetic counseling session for nonpolyposis colorectal carcinoma (HNPCC) and again one month and one year after disclosure of the test results. The prevalence of major and minor depression, acute stress disorder, posttraumatic stress disorder (PTSD), and posttraumatic stress symptoms (PTSS) were assessed using the Structured Clinical Interview based on the Diagnostic and Statistical Manual of Mental Disorders, 3^<rd> edition revised (DSM-III-R) or the DSM-IV. Factors associated with psychological impacts one month after disclosure of the test results were assessed.Results : Among 47 participants who completed the baseline interview, 42 participants (89%) and 30 participants (64%) completed the 1-month and 1-year follow-up interview, respectively. Although none of the participants met the criteria for major depression, ASD, or PTSD at the follow up interview, 3 of 42 participants and 4 of 30 participants met the criteria for minor depression, and 2 and 3 participants had PTSS. The predictors of psychological impact found were neuroticism and verbal memory dysfunction.Conclusions : Disclosure of genetic test results for HNPCC may not cause significant psychological distress in Japanese probands or relatives. However, healthcare providers should not neglect to assess these individuals for psychological responses, such as minor depression and PUSS. Furthermore, it was suggested that constructing of follow-up system for the subjects who have the above risk factors makes it possible to minimize psychological impacts after disclosure of the test results.

目的：本研究的目的是确定日本先证者和未受影响的亲属在测试结果披露后一个月和一年内心理影响的患病率和预测因素。方法：在第一次遗传咨询后立即对先证者和未受影响的亲属进行访谈对于非息肉病性结直肠癌（HNPCC），以及在测试结果公开一个月和一年后再次进行。使用基于《精神疾病诊断和统计手册》第 3 版的结构化临床访谈评估重度和轻度抑郁症、急性应激障碍、创伤后应激障碍 (PTSD) 和创伤后应激症状 (PTSS) 的患病率修订版（DSM-III-R）或 DSM-IV。测试结果公布一个月后，对与心理影响相关的因素进行了评估。结果：在完成基线访谈的 47 名参与者中，42 名参与者 (89%) 和 30 名参与者 (64%) 完成了 1 个月和 1 年的随访分别进行采访。尽管在后续访谈中没有参与者符合重度抑郁症、自闭症谱系障碍或创伤后应激障碍的标准，但 42 名参与者中的 3 名和 30 名参与者中的 4 名符合轻度抑郁症的标准，2 名和 3 名参与者患有 PTSS。发现的心理影响的预测因素是神经质和言语记忆功能障碍。结论：HNPCC 基因检测结果的披露可能不会对日本先证者或亲属造成显着的心理困扰。然而，医疗保健提供者不应忽视评估这些人的心理反应，例如轻微抑郁症和 PUSS。此外，有人建议，对具有上述危险因素的受试者建立随访系统，可以最大限度地减少检测结果披露后的心理影响。