Effect of anxiety and depression on quality of life and cellular immunity in patients with digestive tract cancers

    WEI Yongª²Chang1, NAN Keª²Jun1, ZHOU Fuª²Ling2, MA Xianª²Cang3, WU Mingª²Xia2, HUI Lingª²Yun4, WEI Yuanª²Long4, GAO Chengª²Ge3

    1Department of Medical Oncology, 3Department of Psychology, 4Research Center of Medical Laboratory, First Hospital, Xi¬ðan Jiaotong University, Xi¬ðan 710061, China, 2Department of Hematology and Oncology, Second Hospital, Xi¬ðan Jiaotong University, Xi¬ðan 710004, China,

    ¡¾Abstract¡¿ AIM: To explore the impact of anxiety and depression (AD) on quality of life (QL) and cellular immunity in patients with digestive tract cancers. METHODS: All adult patients were evaluated respectively with the Hamilton anxiety scale (HAMA), the Hamilton depressive scale (HAMD), quality of life questionnaireª²core 30 (QLQª²C30), social support rating scale (SSRS), simple coping style questionnaire (SCSQ) and other questionnaires. Depressive and anxiety disorder diagnoses were assessed by both HAMA and HAMD. The patients were categorized as AD (n=62) in group A, anxiety disorder (n=40) in group B, depressive disorder (n=63) in group C, and nonª²disorder (n=118) in group D. Immunological parameters such as Tª²lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared between the four groups. RESULTS: The incidence of AD was 21.9% in patients with digestive tract cancers. Compared with that in control group D, the score of subjective support was enhanced slightly in group A, while the score of social support and objective support declined, and the utilization of support declined significantly (P<0.05). The total scores of actively coping attitude decreased, while that of passively coping attitude was somewhat higher compared with those in control group (P<0.05). in group A, granulocytes rose, but monocytes reduced and lymphocytes decreased significantly (P<0.05). The percentage of CD3, CD4, CD8 and CD56 in T lymphocyte subsets was respectively lower and CD56 showed a significant decline in group A (P<0.05). Oneª²way ANOVA indicated that the physical function, role function, fatigue, sleeplessness and constipation had significant changes in all groups, but the QL was the worst in group A.. AD was found to be negatively correlated with actively coping attitude and QL. The stepª²wise regression analysis suggested that CD56, actively coping attitude, fatigue, sleeplessness, depression and the utilization of support were significant factors contributing to QL. CONCLUSION: AD, which can impair QL and cellular immunity, is of a higher incidence in patients with digestive tract cancers. ......