Risk of Major Depression Among Breast Cancer Patients

乳腺癌患者患重度抑郁症的风险

• 批准号: 6542862
• 负责人: JAMES C COYNE
• 金额: $ 56.21万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-04 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6542862
• 关键词: antidepressants; behavioral /social science research tag; breast neoplasms; case history; clinical research; comorbidity; diagnosis design /evaluation; disease /disorder etiology; disease /disorder proneness /risk; female; human subject; interview; longitudinal human study; major depression; mental disorder chemotherapy; mental disorder diagnosis; mental health epidemiology; pathologic process; patient care management; psychological aspect of cancer; psychological stressor; women's health

DESCRIPTION (provided by applicant): This project examines the risk for MDD in breast cancer (BC) patients. The overarching hypothesis is that although distress highly prevalent, risk for MDD is moderate and predictable past history of MDD in combination with current distress, but is largely treated inadequately. The first aim is to assess the prevalence, nature, course, and co-morbidity of psychological distress and MDD at entry into cancer and across treatment. The second aim is to test rival hypotheses regarding risk for MDD over the course of the cancer experience with reference to psychological distress and past history of MDD. The third specific aim is to examine the extent, correlates, and outcome of clinician detection and intervention for MDD in routine cancer care. The fourth specific aim is to examine the effects of inclusive, exclusive, and substitutive diagnostic strategies on the nature and prevalence of diagnosed MDD. The project involves multi-stage screening/clinical interviewing for new BC patients, and selection of a stratified sample on the basis of psychological distress, current MDD, and history of MDD. Five groups of women will be followed over this 12-month longitudinal study. One group will consist of women with current MDD. The other groups will consist of nondepressed women nested within a 2 (distressed/nondistressed) x 2 (history/no-history of depression) design. Relevant variables will be assessed via self-report and interview, and chart abstractions will assess staging of BC and current medical and psychiatric treatments. Cancer clinicians will rate the women for distress, depression, functional status and suitability for treatment. Women will be reassessed at 3, 6, 9, and 12 months. This project has important clinical, mental health services, public policy implications. It will provide data essential to establishing the mental health needs of BC patients and the rational design of services to meet these needs. It will allow the design of algorithms for the prevention, detection, and treatment of MDD. Results will also have implications for the training of oncologists, as well as mental health and primary care clinicians who provide the bulk of mental health services to patients and survivors outside the cancer setting.

描述（由申请人提供）：该项目检查了乳腺癌（BC）患者中MDD的风险。 总体假设是，尽管困扰高度普遍，但MDD的风险是中等且可预测的MDD与当前困扰相结合的过去的历史，但在很大程度上是不充分的。 第一个目的是评估心理困扰和MDD进入癌症和跨治疗时心理困扰和MDD的流行率，性质，过程和合并症。 第二个目的是检验有关MDD在癌症经验过程中有关心理困扰和过去MDD历史的竞争对手假设。 第三个具体目的是检查常规癌症护理中临床医生检测和MDD干预的程度，相关性和结果。 第四个具体目的是检查包容性，独家和替代诊断策略对诊断为MDD的性质和患病率的影响。 该项目涉及对新卑诗省患者的多阶段筛查/临床访谈，以及根据心理困扰，当前的MDD和MDD病史选择分层样本的项目。 这项为期12个月的纵向研究将遵循五组妇女。 一组将由当前MDD的妇女组成。 其他群体将由嵌套在2（遇难/非分布）x 2（历史/抑郁史的历史）设计中的非抑郁妇女组成。 相关变量将通过自我报告和访谈进行评估，图表摘要将评估卑诗省和当前的医学和精神疗法的分期。 癌症临床医生将为妇女评估遇险，抑郁，功能状况和适合治疗的能力。 妇女将在3、6、9和12个月重新评估。 该项目具有重要的临床，心理健康服务，公共政策的影响。 它将为确定卑诗省患者的心理健康需求以及满足这些需求的合理设计提供必不可少的数据。 它将允许设计用于预防，检测和治疗MDD的算法。 结果还将对肿瘤学家的培训以及心理健康和初级保健临床医生的培训产生影响，这些临床医生为癌症环境以外的患者和幸存者提供大量的心理健康服务。