Eventos traumáticos na infância estão associados com a ocorrência de desordens emocionais e variáveis clinicopatológicas em pacientes com câncer de cabeça e pescoço
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Data
2017-08-25
Autores
Silva, Bruna Amélia Moreira Sarafim da [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Eventos traumáticos na infância têm sido associados à ocorrência de ansiedade e depressão na fase adulta. Esta relação tem sido investigada em pacientes com câncer de mama, mas pouco explorada em pacientes com outros tipos de câncer. Objetivo: Avaliar a ocorrência de eventos traumáticos na infância e sua associação com as características clinicopatológicas e desordens emocionais em pacientes com câncer de cabeça e pescoço (CCP). Método: Foram incluídos no estudo 110 pacientes com diagnóstico de carcinoma espinocelular (CEC) de cabeça e pescoço antes de iniciar o tratamento oncológico. Dados clinicopatológicos e biocomportamentais foram coletados dos prontuários clínicos dos pacientes. Os níveis de ansiedade e depressão foram avaliados por meio do Inventário de Ansiedade de Beck (IAB) e o Inventário de Depressão de Beck (IDB), respectivamente. Questionário sobre Trauma na Infância (CTQ) foi utilizado para avaliar a ocorrência de eventos traumáticos na infância. Resultados: A maioria dos pacientes eram homens (88,2%) com tumores localizados na boca (65.6%), laringe (19%) e orofaringe (15.4%). Cento e cinco pacientes (95.5%) relataram pelo menos um tipo de experiência traumática na infância. A negligência emocional foi o subtipo de trauma mais reportado (43.8%) e análise multivariada revelou que ela foi uma variável independente para estadiamento clínico avançado (β=2.15, p=0.048) e maior consumo de álcool (β=2.32, p=0.031). Pacientes com CCP que tiveram maior ocorrência de trauma na infância apresentaram quase 12 vezes mais chance de apresentar níveis elevados de depressão durante o período pré-tratamento (β=11.89; p=0.0002). A ocorrência de negligência física na infância foi preditiva para aumento dos níveis de ansiedade (β=4.17; p=0.029). Conclusão: Eventos traumáticos na infância são preditivos para o estadiamento clínico avançado, consumo de álcool e sintomas psicológicos em pacientes com câncer de cabeça e pescoço e devem ser consideradas nas estratégias de intervenção clínica e psicológica durante o tratamento oncológico.
Introduction: Childhood Traumatic events have been associated with anxiety and depression occurrence in adulthood. This relationship has been investigated in breast cancer patients, however it is little explored in patients with other types of cancer. Objective: To evaluate the childhood trauma occurrence in head and neck cancer (HNC) patients, as well as its association with clinicopathological variables, and anxiety and depression levels. Method: The study included 110 head and neck squamous cell carcinoma (HNSCC) patients before starting cancer treatment. Clinicopathological and biobehavioral data were collected from patient’s medical records. Anxiety and depression levels were assessed by Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), respectively. Childhood Trauma Questionnaire (CTQ) was used to evaluate the childhood traumatic events occurrence. Results: The most of the HNSCC patients was men (88.2%), with tumors located in oral cavity (65.6%), larynx (19%) and oropharynx (15.4%). One hundred and five patients (95.5%) had experienced at least one type of childhood trauma. Emotional neglect was the most reported childhood trauma (43.8%) and multiple regression revealed that it was an independent variable for advanced clinical staging (β=2.15, p=0.048), and higher alcohol consumption (β=2.32, p=0.031). HNSCC patients who had a higher occurrence of traumatic events in childhood had almost 12 times more chances of having increased depression levels during the pre-treatment period (β=11.89; p=0.0002). Childhood physical neglect occurrence was a predictive factor for increased anxiety levels (β = 4.17, p = 0.029). Conclusion: Childhood traumatic events are predictive for advanced clinical staging, alcohol consumption, and emotional disorders in HNSCC patients, and should be considered in clinical and psychological intervention strategies during cancer treatment.
Introduction: Childhood Traumatic events have been associated with anxiety and depression occurrence in adulthood. This relationship has been investigated in breast cancer patients, however it is little explored in patients with other types of cancer. Objective: To evaluate the childhood trauma occurrence in head and neck cancer (HNC) patients, as well as its association with clinicopathological variables, and anxiety and depression levels. Method: The study included 110 head and neck squamous cell carcinoma (HNSCC) patients before starting cancer treatment. Clinicopathological and biobehavioral data were collected from patient’s medical records. Anxiety and depression levels were assessed by Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), respectively. Childhood Trauma Questionnaire (CTQ) was used to evaluate the childhood traumatic events occurrence. Results: The most of the HNSCC patients was men (88.2%), with tumors located in oral cavity (65.6%), larynx (19%) and oropharynx (15.4%). One hundred and five patients (95.5%) had experienced at least one type of childhood trauma. Emotional neglect was the most reported childhood trauma (43.8%) and multiple regression revealed that it was an independent variable for advanced clinical staging (β=2.15, p=0.048), and higher alcohol consumption (β=2.32, p=0.031). HNSCC patients who had a higher occurrence of traumatic events in childhood had almost 12 times more chances of having increased depression levels during the pre-treatment period (β=11.89; p=0.0002). Childhood physical neglect occurrence was a predictive factor for increased anxiety levels (β = 4.17, p = 0.029). Conclusion: Childhood traumatic events are predictive for advanced clinical staging, alcohol consumption, and emotional disorders in HNSCC patients, and should be considered in clinical and psychological intervention strategies during cancer treatment.
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Palavras-chave
Câncer, Trauma psicológico, Adultos sobreviventes de eventos adversos na infância, Neoplasias de cabeça e pescoço, Psychological trauma, Adult survivors of child adverse events, Head and neck neoplasms