The Study Of Association Between Advanced Cancer And Depression

Objective: To investigate the incidence and influencing factors of223patients in advanced cancer withtumor-associated depression and to explore the effects of fluoxetine on the immune function and quality oflife in these patientsMethods: In this study223patients were chosen in the Oncology of the First Affiliated Hospital of DalianMedical University during April2012to March2014who were confirmed advanced cancer by pathologicaland radiological diagnosis and had no depression before Using the DSM-IV (Diagnostic and StatisticalManual IV) to diagnose tumor-associated depression and evaluating the depression assessment according tothe Hamilton Depression Scale (HAMD)(24items)94patients were diagnosed with tumor-associateddepression and129patients were without tumor-associated depression the rate of depression incidencewere42.2%,including84patients with mild-moderate depression and10patients with severe depression.94patients were divided into two groups the control group n=47chemotherapy treatment and the studygroup n=47chemotherapy combined with anti-depression treatment The patients in study group wereexcluded the initial normal psychological reaction after diagnosing with cancer so they could takefluoxetine after diagnosed with depression three weeks later Anti-depressant treatment fluoxetine20mg/dpo continued to take to the end of the two cycles of chemotherapy while patients were finished normalanti-tumor chemotherapy in accordance with the these own situation SPSS17.0was used for the statisticalanalysis of all data, which were expressed as mean±standard deviation the group with depression and thegroup without depression were compared by the chi-square test in gender, age, disease location, KPS score,chemotherapy, prevalence informed and education The study group before and after treatment werecompared by paired t-test The study group and the control group, the two groups were compared by groupt-test for independent samples The Hamilton Depression Rating Scale (24entries), tumor quality of lifetable Chinese version (QLQ-C30) and T cell subsets were used as observed indicators P <0.05wasconsidered as statistically significant.Results In the group with depression and the group without depression the incidence in sex, KPS score, thetype of chemotherapy, prevalence informed and education had statistically significant (P <0.05),and in ageand disease location had no statistically significant (P>0.05)In the study group before and after treatment,QLQ-C30ratings: quality of life scores in body, role,emotional functioning and overall quality of life were rising which had statistically significant(P <0.05)The score in fatigue, pain, insomnia and loss of appetite symptoms were decreasing, which had statisticallysignificant(P <0.05), The scores in cognitive function, social function, nausea, vomiting, shortness ofbreath constipation, diarrhea and economic difficulties had no statistically significant (P>0.05) The scoresof HAMD were decreasing, which had statistically significant(P <0.05) T cell subsets in CD3+, CD4+,CD4+/CD8+were increasing than the treatment before which had statistically significant(P <0.05),CD8+compared with the treatment before and after had no statistically significant (P>0.05)In the control group, T cell subsets compared with treatment before and after CD3+, CD4+/CD8+were increasing which had statistically significant (P <0.05), showing that chemotherapy can reduce the patient’s immune function CD4+CD8+had no statistically significant(P>0.05) The scores of HAMDwere increasing, but had no statistically significant (P<0.05)Comparing the study group and control group CD3+CD4+CD4+/CD8+in the study group hadimproved than the control group, which had statistically significant(P <0.05), CD8+had no statisticallysignificant(P>0.05) The quality of life in emotional functioning, insomnia, pain loss of appetite andoverall quality of life had improved which had statistically significant(P <0.05)Conclusion Among the patients with advanced cancer tumor-associated depression women, loweducational level, low KPS score, many kinds of chemotherapy, and insiders had high incidence we shouldpay more attention to their psychological assessment and have early detection and timely treatment so thatthe quality of life could be improved Taking fluoxetine can improve depression quality of life andimmune function in the patients with tumor-associated depression and prolong survival...