AKCÝÐER KANSERLÝ HASTALARDA ANKSÝYETE VE DEPRESYON DÜZEYLERÝNDEKÝ DEÐÝÞÝMLER

Bu çalýþmanýn amacý; akciðer kanserinin taný ve tedavi sürecinde, hasta uyumu ve performansýný bozmasý beklenen anksiyete ve depresyon düzeylerindeki deðiþimlerin incelenmesidir. Anksiyete ve depresyon düzey leri, akciðer kanseri ön tanýlý hastalarda yatýþta ve tanýsal giriþim öncesinde, akciðer kanseri kanýtlananlarda ise tedavi baþlangýcýndan 1 ay sonra, Hastane Anksiyete Depresyon (HAD) skalasý kullanýlarak deðerlendirildi. Yaþ, Eastern Cooperative Oncology Group (ECOG) performans durumu, histolojik tip ve hastalýðýn evresine göre, HAD skorlarýndaki deðiþiklikler karþýlaþtýrýldý. 103 akciðer kanseri hastasýnda (yaþ: 61.4±0.98) anksiyete ve depresyon sýrasýyla, hastaneye yatýþta %25 ve %36, tanýsal giriþim öncesinde %21 ve %38 ve tedaviden sonra %21 ve %42 oranýnda saptandý. Anksiyete ve depresyon skorlarý sýrasýyla, yatýþta 6.01±0.62 ve 6.55±0.60, tanýsal giriþim öncesinde 5.98±0.58 ve 6.32±0.53 ve tedaviden sonra 6.23±0.57 ve 6.79±0.50 idi. Anksiyete ve depresyon skorlarýnda, histolojik, hastalýk evresi ve tedaviye göre önemli fark saptanmadý. 65 yaþ üstü hastalarda, 65 yaþ altýndaki hastalara göre 2. görüþmede anksiyete, 2. ve 3. görüþmelerde depresyon varlýðý istatistiksel olarak daha yüksekti. ECOG 2 olan hastalarda ECOG 1 olan hastalara kýyasla genel olarak görüþmelerde anksiyete ve depresyon varlýðý daha yüksekti. Akciðer kanserinde anksiyete ve depresyon önemli oran ve düzeylerde izlenmekte olup, hastalýk evresi ve önemli ölçüde de taný ve tedavi sürecinden baðýmsýzdýr. Depresyon ve anksiyete düzeyi performans durumu kötüleþmesi ve yaþýn artýþý ile birlikte artmaktadýr.

CHANGES IN ANXIETY AND DEPRESSION LEVELS AT THE PATIENTS WITH LUNG CANCER

The aim of this study is to study changes in anxiety and depression levels expected to disturb patient compliance and performance during the diagnosis and the treatment of lung cancer. Levels of anxiety and depression were assessed by using Hospital Anxiety Depression (HAD) scale at admission and before diagnostic intervention in patients with presumptive lung cancer diagnosis, and also at the first month after the start of treatment in those with confirmed lung cancer. Differences in HAD scores were compared regarding age, Eastern Oncology Group (ECOG) performance status and disease stage. In 103 lung cancer patients (age: 61.4±0.98), anxiety and depression were determined, respectively, at rates of 25% and 36% at admission, 21% and 38% before diagnostic intervention, 21% and 42% after treatment. Anxiety and depression scores were, respectively, 6.01±0.62 and 6.55±0.60 at admission, 5.98±0.58 and 6.32±0.53 before diagnostic intervention and 6.23±0.57 and 6.79±0.50 after treatment. No significant difference was found in anxiety and depression scores regarding disease stage and therapy. On the second interview anxiety was seen higher at the patients with more than 65 years comparing with below 65 years, and on the second and third interviews the depression was seen higher istatistically. Generally, the presence of anxiety and depression was relatively higher at the patients with ECOG 2 than the patients with ECOG 1 on the interviews. Anxiety and depression, observed at significant rates and levels in lung cancer, are independent of disease stage and, greatly, of management course. The level of depression and anxiety arises with the deterioration of performance and the advance of aging.