Clinical Characteristics Of Anxiety,Depression And Insomnia In Patients With Hematologic Malignancies

Background Hematologic maligananices(HM),originates from the hematopoietic system,as one of the common malignant tumors,has a high degree of malignancy.Hematologic maligananices patients often along with the regular hospitalization?complicated treatment progress and multiple complications.It is a group of diseases that threaten human health seriously.Some studies have suggested that a considerable proportion of patients have strong psychological symptoms in the stage of diagnosis and intensive treatmen,such as anxiety,depression and insomnia,which reduce the quality of life of patients greatly and affect the treatment and recovery of patients seriously.Therefore,it has become an urgent task for clinicians to identify,correct,improve and treat early for these patients who sufferd sychological symptoms.Objective Analyze the incidence of anxiety,depression and insomnia in patients with malignant blood diseases and their related factors,aim to provide scientific basis for reducing the psychological pressure,improving quality of life of such patients and optimizing the treatment plan.Method The data was obtained from the department of hematology,Chaohu Hospital of Anhui Medical University.Between February 2019 and August,a total of 115 patients who were diagnosed of malignant blood diseases and a total of 30 were not Malignant blood disease during the same period were enrolled in the stuy.The inclusion criteria were in line with the 3rd edition of?Blood Disease Ddiagnosis and Efficacy Criteria? edited by zhang zhinan,and the patients had good reading ability and response ability,clear consciousness,and were not with serious heart,brain,lung and other complications.They volunteered to participate in this study.All patients were asked to writ informed conset.The data were obtained from the self-administered questionaires:SAS?SDS?ISI.Explain the research purpose and the scale fillng methods to the patient's in detail.Then we need to recover the scale,and analyze the data.Evaluate the incidence of insomnia of anxiety,depression and insomnia in patients with hematologic malignancies and compared with the no-malignant mood disease,statistic Socio-demographic and clinical data,including gender,age,education,occupation,economic level,the types of disease,complications,number of chemotherapy,etc.And analyze the influencing factors of hospitalized patients with hematologic malignancies of anxiety,depression,and insomnia,draw the conclusion.Statistical analysis:SPSS22.0 software was used for all the data analyses.The measuement data subject to normal distribution were expressed as mean ± standard devation((?)± ),HM patients were divided into anxiety/non-anxiety ?depression/non-depression?insomnia/non-insomnia three groups.?~2 test was used to analyze the relevant factors of patients with malignant blood disease among the three groups.When the number of cases was>40,but 1?the theoretical frequency was<5(T is the theoretical frequency),using correct ?~2 test.Multi-factor logistic regression analysis was used to analyze the risk factors of anxiety,depression and insomnia.Results 1.Overall incidence of anxiety,depression and insomnia: 115 HM patients group: the incidence of anxiety was 31.3%(36 cases),SAS score was 53.13±8.37;the incidence of depression was 45.22%(52 cases),SDS score was 56.53±9.29;the incidence of insomnia was 20.87(24 cases)%,and the ISI score was 9.17±5.00.30 non-HM patients group: the incidence of anxiety was 10%(3 cases),SAS score 45.33±4.34;the incidence of depression was 13.3%(4 cases),SDS score 45.03±3.88;the incidence of insomnia was 20%(6 cases),ISI score 6.23±1.96.2.Results of analysis of factors associated with anxiety,depression and insomnia in HM patients.(1)Anxiety: single factor analysis results: smoking status,complications,ADL scores,pain score on the incidence of anxiety in the patients with HM statistical differences(P<0.05),and different gender,age,education background,occupation,marital status,income per person,family support,disease types,duration,number of chemotherapy in patients with HM anxiety on the incidence of no significant statistical difference(P> 0.05);Results of multivariate analysis: smoking and complications were independent risk factors for anxiety in HM patients.(2)Depression: single factor analysis results: different age,education background,occupation,family support,per capita income,marital status,course,complications,ADL scores,pain score on the incidence of depression in patients with hematologic malignancies statistical differences(P<0.05),but different gender,different number of chemotherapy,different types of diseases,smoking status on the incidence of depression in patients with HM no significant statistical difference(P>0.05);Results of multivariate analysis: per capita income and comorbidization were independent risk factors for depression in HM patients.(3)Insomnia: single factor analysis results,different careers,disease types,ADL scores,pain score on the HM insomnia incidence statistical differences(P<0.05),gender,education background,age,number of chemotherapy,smoking status,duration,family support,per capita monthly income and marital status on the HM patients insomnia incidence no significant statistical difference(P>0.05).Results of multivariate analysis: pain score was an independent risk factor for insomnia in HM patients.Conclusion Anxiety,depression and insomnia are common in patients with malignant blood diseases,which smoking and complications are closely related to anxiety,per capita monthly income and complications are closely related to depression,and pain score is closely related to insomnia.