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: 6782553
• 负责人: JAMES C COYNE
• 金额: $ 63.95万
• 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 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6782553
• 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）：该项目检查乳腺癌 (BC) 患者患 MDD 的风险。 总体假设是，虽然抑郁症非常普遍，但患 MDD 的风险是中等的，并且可以预测过去的 MDD 病史与当前的抑郁症相结合，但很大程度上没有得到充分的治疗。 第一个目标是评估进入癌症和治疗过程中心理困扰和 MDD 的患病率、性质、病程和共病情况。 第二个目的是参考心理困扰和 MDD 既往史，检验关于癌症经历过程中 MDD 风险的对立假设。 第三个具体目标是检查临床医生在常规癌症护理中 MDD 检测和干预的程度、相关性和结果。 第四个具体目标是检查包容性、排他性和替代性诊断策略对诊断性 MDD 的性质和患病率的影响。 该项目涉及对新 BC 患者进行多阶段筛查/临床访谈，并根据心理困扰、当前 MDD 和 MDD 病史选择分层样本。 这项为期 12 个月的纵向研究将跟踪五组女性。 一组将由患有重度抑郁症的女性组成。 其他组将由嵌套在 2（痛苦/非痛苦）x 2（有抑郁史/无抑郁史）设计中的非抑郁女性组成。 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 BC 的分期以及当前的医疗和精神治疗。 癌症临床医生将对女性的痛苦、抑郁、功能状态和治疗适合性进行评估。 女性将在 3、6、9 和 12 个月时接受重新评估。 该项目具有重要的临床、心理健康服务、公共政策影响。 它将提供对于确定 BC 患者的心理健康需求以及合理设计满足这些需求的服务至关重要的数据。 它将允许设计用于预防、检测和治疗 MDD 的算法。 研究结果还将对肿瘤学家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以外的患者和幸存者提供大量心理健康服务。