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J Clin Oncol:癌症幸存者焦虑和抑郁用药情况 你造吗?

2017-04-13 选题审校:韩茹 编辑:吴星 环球医学编译

专家点评:奥氮平的off label使用中,有一种作用便是止吐,临床上有应用,指南也有所更新;而且奥氮平具有价更廉的优势。此外,对于难治性高血压,也可以使用奥氮平,地西泮等药物,主要是发挥其镇静的作用。

癌症患者和癌症幸存者通常会变得抑郁、焦虑或面临其它形式的情感抑郁。2017年1月,发表在《J Clin Oncol.》的一项研究调查了美国癌症幸存者焦虑和抑郁用药情况。结果表明,美国癌症幸存者报告焦虑和抑郁用药的比例几乎是普通人群的2倍。

目的:该研究使用基于人群的数据,估算美国癌症幸存者报告目前使用药物治疗焦虑和抑郁的比例,并描述使用该类药物的幸存者的特征。考察与普通人群相比,癌症幸存者使用药物的比例。

方法:研究者分析了2010年至2013年美国健康采访调查的数据,确定完成样本成人核心问卷(the Sample Adult Core Questionnaire)和成人功能和残疾补助(the Adult Functioning and Disability Supplement)的癌症幸存者(n = 3184)以及无癌症病史的成人(n = 44997)

结果:与无癌症病史的成人相比,癌症幸存者更显着报告使用药物治疗焦虑(16.8% v 8.6%,P<0.001)和抑郁(14.1% v 7.8%,P<0.001)、治疗其中一种疾病或两者兼治(19.1% v 10.4%,P<0.001)的可能,表明当时美国有250万癌症幸存者使用药物治疗焦虑和抑郁。与更高焦虑用药比例相关的幸存者特征包括年龄小于65岁、女性、非西班牙裔白人、参加公共保险、药物治疗的常规资源、多种慢性健康疾病。除了保险状况不显着以外,抑郁用药相关幸存者特征与焦虑用药相关幸存者特征大致一致,寡居、离婚和单身与更多用药相关。

结果:美国癌症幸存者报告焦虑和抑郁用药的比例几乎是普通人群的2倍,反映出癌症或癌症治疗带来的的巨大情感和身体压力。

原文出处:Hawkins NA,et al.Use of Medications for Treating Anxiety and Depression in Cancer Survivors in the United States.J Clin Oncol. 2017 Jan;35(1):78-85. Epub 2016 Oct 23.

(专家点评:奥氮平的off label使用中,有一种作用便是止吐,临床上有应用,指南也有所更新;而且奥氮平具有价更廉的优势。此外,对于难治性高血压,也可以使用奥氮平,地西泮等药物,主要是发挥其镇静的作用。)

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1798644, encodeId=02121e98644ff, content=<a href='/topic/show?id=7c0f69684af' target=_blank style='color:#2F92EE;'>#用药情况#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69684, encryptionId=7c0f69684af, topicName=用药情况)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e183245, createdName=Eleven11, createdTime=Mon Jan 29 00:55:00 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1864889, encodeId=e9e218648891a, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Dec 26 13:55:00 CST 2017, time=2017-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188461, encodeId=c547188461a5, content=文章不错,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Apr 18 08:36:47 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187795, encodeId=953118e795c6, content=认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sun Apr 16 04:21:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438779, encodeId=3c811438e7947, content=<a href='/topic/show?id=5e61e13494d' target=_blank style='color:#2F92EE;'>#癌症幸存者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71349, encryptionId=5e61e13494d, topicName=癌症幸存者)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 15 02:55:00 CST 2017, time=2017-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187373, encodeId=009c18e373f1, content=mark, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/02/48d1fec880a796cc2ad284d7b18e6017.jpg, createdBy=43e51704272, createdName=九天., createdTime=Fri Apr 14 14:12:16 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    2017-12-26 minlingfeng
  3. [GetPortalCommentsPageByObjectIdResponse(id=1798644, encodeId=02121e98644ff, content=<a href='/topic/show?id=7c0f69684af' target=_blank style='color:#2F92EE;'>#用药情况#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69684, encryptionId=7c0f69684af, topicName=用药情况)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e183245, createdName=Eleven11, createdTime=Mon Jan 29 00:55:00 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1864889, encodeId=e9e218648891a, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Dec 26 13:55:00 CST 2017, time=2017-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188461, encodeId=c547188461a5, content=文章不错,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Apr 18 08:36:47 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187795, encodeId=953118e795c6, content=认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sun Apr 16 04:21:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438779, encodeId=3c811438e7947, content=<a href='/topic/show?id=5e61e13494d' target=_blank style='color:#2F92EE;'>#癌症幸存者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71349, encryptionId=5e61e13494d, topicName=癌症幸存者)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 15 02:55:00 CST 2017, time=2017-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187373, encodeId=009c18e373f1, content=mark, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/02/48d1fec880a796cc2ad284d7b18e6017.jpg, createdBy=43e51704272, createdName=九天., createdTime=Fri Apr 14 14:12:16 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    2017-04-18 1e10c84am36(暂无匿称)

    文章不错,拜读了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1798644, encodeId=02121e98644ff, content=<a href='/topic/show?id=7c0f69684af' target=_blank style='color:#2F92EE;'>#用药情况#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69684, encryptionId=7c0f69684af, topicName=用药情况)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e183245, createdName=Eleven11, createdTime=Mon Jan 29 00:55:00 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1864889, encodeId=e9e218648891a, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Dec 26 13:55:00 CST 2017, time=2017-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188461, encodeId=c547188461a5, content=文章不错,拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Apr 18 08:36:47 CST 2017, time=2017-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187795, encodeId=953118e795c6, content=认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sun Apr 16 04:21:00 CST 2017, time=2017-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438779, encodeId=3c811438e7947, content=<a href='/topic/show?id=5e61e13494d' target=_blank style='color:#2F92EE;'>#癌症幸存者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71349, encryptionId=5e61e13494d, topicName=癌症幸存者)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Apr 15 02:55:00 CST 2017, time=2017-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187373, encodeId=009c18e373f1, content=mark, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/02/48d1fec880a796cc2ad284d7b18e6017.jpg, createdBy=43e51704272, createdName=九天., createdTime=Fri Apr 14 14:12:16 CST 2017, time=2017-04-14, status=1, ipAttribution=)]
    2017-04-16 ylzr123

    认真学习,把间接经验应用到临床实践中去,然后再总结出新思路。

    0

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    2017-04-14 九天.

    mark

    0

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