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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2023.tde-20062023-155057
Document
Author
Full name
Marcia Cavalcanti Lacerda
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2022
Supervisor
Committee
Castro Junior, Gilberto de (President)
Baia, Wania Regina Mollo
Campolina, Alessandro Gonçalves
Possari, João Francisco
Title in Portuguese
Identificação de depressão, ansiedade e de risco para suicídio em pacientes com câncer de cabeça e pescoço
Keywords in Portuguese
Ansiedade
Câncer de cabeça e pescoço
Depressão
Suicídio
Transtornos de Ansiedade
Tristeza
Abstract in Portuguese
Transtornos mentais, incluindo ansiedade e depressão, são muito frequentes na população brasileira. Observa-se maior risco para suicídio em pacientes com câncer naqueles diagnosticados com câncer de cabeça e pescoço, uma doença associada a vários estigmas e ainda com elevada mortalidade. Neste estudo foram avaliados os riscos de ansiedade, depressão e risco de suicídio em pacientes com câncer de cabeça e pescoço localmente avançado, com indicação de quimioterapia e radioterapia concomitantes, antes da primeira consulta ambulatorial com o médico Oncologista Clínico, através da aplicação dos questionários de avaliação Hospital Anxiety and Depression Scale (HADS) e Inventário Beck de Ideação Suicida (BSI), após consentimento livre e esclarecido. Entre novembro/2021 e junho/2022, 55 pacientes foram avaliados e responderam aos questionários propostos. Destes, 32 eram do sexo masculino (58%) e com mediana de 61 anos de idade (21-89). Em termos de escolaridade, 20 pacientes declararam possuir nível secundário (36%), 13 pacientes tinham nível primário (24%), 11 pacientes sabiam ler e escrever (20%), e 4 deles declararam ser analfabetos (7 %). Quanto ao estado civil, 19 eram casados (35%) e 20 divorciados e/ou separados (36%); 32 referiram ser católicos (58%) e 45 pacientes (82%) tinham uma renda familiar de 1 a 3 salários mínimos. Na avaliação sobre o etilismo, 26 eram atuais etilistas (47%), e em relação ao tabagismo, a maior parte dos pacientes entrevistados era tabagista (29 pacientes, 53%) e 10 ex-tabagistas (18%). O sítio primário mais frequente do carcinoma de cabeça e pescoço foi a boca, em 33 pacientes (60%). Segundo as somas do questionário HADS, 28 pacientes (51%) pontuaram de 0 a 7, ou seja, improvável para ansiedade; 19 (35%) pontuaram de 8 a 11, com possível ansiedade; e 8 deles pontuaram de 12 a 21 (14%), sendo a ansiedade provável nestes pacientes. Quanto à depressão, 40 pacientes (73%) pontuaram de 0 a 7, ou seja, improvável para depressão; 10 (18%) pontuaram de 8 a 11, com possível depressão; e 5 deles pontuaram de 12 a 21 (9%), sendo a depressão provável nestes pacientes. Dos 5 pacientes com risco provável para depressão, 3 eram homens, e destes 5 pacientes, nenhum era casado ou mantinha um relacionamento e todos os 5 pacientes declararam uma renda familiar entre 1 a 3 salários mínimos. A pontuação máxima atingida para ansiedade foi 15 pontos, em um único paciente e para depressão, foi 13 pontos, em 2 pacientes. Na avaliação da Psicologia, onde foi aplicado o BSI para avaliar a ideação suicida, dos 25 participantes avaliados, nenhum apresentou risco para suicídio. Em conclusão, o risco para ansiedade e depressão parece ser alto nessa população, mas sem apresentar risco de ideação suicida
Title in English
Identification of depression, anxiety and suicide risk in patients with head and neck cancer
Keywords in English
Anxiety
Anxiety desorders
Depression
Head and neck neoplasms
Sadness
Suicide
Abstract in English
Mental disorders, including anxiety and depression, are very common in the Brazilian population. A higher risk of suicide is observed in patients with head and neck cancer, disease associated with various stigmas and with high mortality. In this study, the risks of anxiety, depression and suicide were evaluated in patients with locally advanced head and neck cancer, with indication for concurrent chemotherapy and radiotherapy, before the first outpatient consultation with the Clinical Oncology team, through the application of the questionnaires Hospital Anxiety and Depression Scale (HADS) and Beck Suicide Ideation Inventory (BSI), after informed consent. Between November/2021 and June/2022, 55 patients were evaluated and answered the proposed questionnaires. Of these, 32 were male (58%) with median age of 61 years (21-89). Twenty patients declared having a secondary level of education (36%), 13 patients had a primary level (24%), 11 patients could only read and write (20%), and 4 declared to be illiterate (7%). As for marital status, 19 were married (35%) and 20 were divorced (36%); 32 reported being Catholic (58%) and 45 patients (82%) had a family income of 1 to 3 minimum wages. In the assessment of alcoholism, 26 were current drinkers (47%), and regarding smoking, most of the interviewed patients were current smokers (29 patients, 53%) and 10 were former smokers (18%). The most frequent primary site of head and neck carcinoma was the mouth, in 33 patients (60%). According to the HADS questionnaire, 28 patients (51%) scored from 0 to 7, unlikely for anxiety; 19 (35%) scored from 8 to 11, with possible anxiety; and 8 of them scored from 12 to 21 (14%), anxiety being likely in these patients. As for depression, 40 patients (73%) scored from 0 to 7, unlikely for depression; 10 (18%) scored from 8 to 11, with possible depression; and 5 of them scored from 12 to 21 (9%), with depression being likely in these patients. Of the 5 patients at a likely risk for depression, 3 were men, and out of these 5 patients, none was, and all 5 patients declared a family income between 1 and 3 minimum wages. The maximum score reached for anxiety was 15 points, in a single patient, and for depression, 13 points, in 2 patients. In the Psychologic evaluation, being the BSI to assess suicidal ideation, none was at risk for suicide out of the 25 participants evaluated. In conclusion, the risk for anxiety and depression seems to be high in this population, but without risk of suicidal ideation
 
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Publishing Date
2023-07-04
 
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