癌症病人之創傷後壓力症、憂鬱及自殺風險

Post-Traumatic Syndrome, Depression and Suicide among Cancer Survivors

10.6530/YYN.201907_13(2).0001

戴月明(Yueh-Ming Tai)；楊斯年(Szu-Nian Yang)

癌症 ； 創傷後壓力症 ； 憂鬱 ； 自殺 ； cancer ； post-traumatic stress syndrome ； depression ； suicidality

源遠護理

13卷2期（2019 / 07 / 01）

5 - 8

繁體中文

研究發現癌症病人，其中68%曾經歷適應障礙症（Adjustment disorder）、13%經歷過憂鬱症、4%經歷焦慮症等症狀。即使未有精神科診斷之癌症病人，亦在臨床上呈現有明顯較高的憂鬱、焦慮、身體症狀及畏懼症狀。研究發現約15.3%的癌症病人會符合創傷後壓力症（PTSD）診斷，且以反覆瀕死經驗、身體症狀及感到麻木失真感為主。而這些症狀都與病前曾經歷創傷精驗及／或生活品質降低有關。雖然癌症病人在聽聞罹癌診斷後，憂鬱情緒是必經的情緒過程，然而在施用的抗癌藥物中，確也有會引起憂鬱的副作用。癌症個案自殺率是一般人的兩倍，而男性高於女性，年齡越大自殺率越高，自殺率最高常在癌症診斷後的第一年。鑑於憂鬱本身會造成身體免疫功能降低，而最新研究發現免疫療法應是未來癌症治療另一希望。故早期發現、早期會診及早期處理，應是可提昇個案生活品質、減少自殺風險及提昇免疫力的一大良方。

About 68% of cancer survivors suffered from adjustment disorder, 13% from depression and 4% from anxiety related disorders. Many cancer survivors, without a psychiatric diagnosis, also experience relatively high levels of depression, anxiety, somatization and phobia. Researchers found that about 15% of cancer survivors reported symptoms of post-traumatic stress disorder (PTSD); re-experience of dying, somatization, numbing, and symptoms related to personal past live events/life quality. Besides cancer itself, side effects of some cancer treatment agents may also cause depression. Suicide commit rate among cancer survivors is two-fold of the general population; it is relatively higher in the male and in the elderly. The highest suicide rate occurred within the first year of diagnosis. Depression may negatively impact a person's immune system; therefore, it is reasonable to assume that early detecting, early consulting, and early management of depression might maleate symptoms related to cancer in terms of immune function enhancement among cancer survivors.

1. 馬靖超,戴月明(2014)。以五題簡式健康量表（BSRS-5）篩選分數來評估新兵自殺的危險性。臺灣精神醫學，28(2)，109-120。
   連結：
2. Abbey, G.,Thompson, S. B.,Hickish, T.,Heathcote, D.(2015).A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder.Psychooncology,24(4),371-381.
3. Anguiano, L.,Mayer, D. K.,Piven, M. L.,Rosenstein, D.(2012).A literature review of suicide in cancer patients.Cancer Nursing,35(4),E14-E26.
4. Cordova, M. J.,Riba, M. B.,Spiegel, D.(2017).Post-traumatic stress disorder and cancer.The Lancet Psychiatry,4(4),330-338.
5. Derogatis, L. R.,Morrow, G. R.,Fetting, J.,Penman, D.,Piasetsky, S.,Schmale, A. M.,Carnicke, C. L.(1983).The prevalence of psychiatric disorders among cancer patients.Journal of the American Medical Association,249(6),751-757.

1. 王靜婷(Jing-Ting Wang);吳珮菁(Pei-Ching Wu)(2024)。一位壯年男性初次罹患舌癌之術後護理經驗。高雄護理雜誌。41(1)。135-146。