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Depresión en pacientes con dolor oncológico / Depression in Patients with Oncologic Pain
Romeo, Adriana Beatriz.
  • Romeo, Adriana Beatriz; Instituto de Oncología. AR
Psicofarmacologia (B. Aires) ; 14(85): 7-16, apr.2014. graf
Article in Spanish | LILACS | ID: lil-777901
RESUMEN
Prospectiva, longitudinal, observacional sobre una población de 104 pacientes, representativa de las neoplasias de nuestra región, que padecían de dolor oncológico y síntomas depresivos. Objetivos generales definir las características peculiares del dolor oncológico. Establecer el valor del diagnóstico diferencial de los síntomas. Investigar los niveles del cortisol a fin de precisar su importancia como marcador biológico. Objetivo específico establecer si el control farmacológico de la depresión asociada pudiera tener algún efecto útil sobre el dolor neoplásico y la calidad de vida subsiguiente.

Metodología:

todos los pacientes ingresados recibieron analgésicos siguiendo pautas de la OMS. 50 p (48,07 %) continuaron igual tratamiento Grupo I (control) 54 p (51,93 %) sumaron antidepresivos Grupo II (previo al dolor 15 p). Grupo III (desde el dolor 39 p). El diagnóstico de trastorno depresivo se llevó a cabo según criterios del DSM-IV. La intensidad del dolor se cuantificó por interrogatorio con respuestas libres (RL) y escala verbal (EV), la escala numérica (EN), la escala visual analógica (EVA) y completando el McGill pain questionnaire MPQ (con adecuaciones de compatibilización), la inensidad de la depresión, por medio del inventario de depresión de Beck (BDI) y se midió el cortisol salival. Al tercer mes se repitieron iguales parámetros y se compararon ambas mediciones con metodología bioestadística apropiada. Al cuarto mes se efectuó reunión de consenso con familiares y médico de cabecera para analizar los efectos sobre la calidad de vida que se cuantificaron para su análisis matemático.

Resultados:

se define como cancroalgia al dolor de características específicas provocado por el crecimiento infiltrativo inflamatorio y distorsivo del tumor primario o sus metástasis. 95 % de los pacientes con dolor oncológico padecían trastornos depresivos. Los niveles del cortisol no presentaron variaciones significativas...
ABSTRACT
Prospective, longitudinal, observational about a population of 104 patients, which is reprresentative of our region's neoplasias and which suffered from oncologic pain and depressive symptoms. General

objectives:

To define the peculiar characteristics of oncologic pain. To establish the importance of the differential diagnosis of the symptoms. To investigate the levels of cortisol so as to determine its relevance as biological marker. Specific

objective:

To establish whether the pharmacological control of associated depression might have any useful effect on neoplastic pain and the subsequent quality of life.

Methodology:

All the patients enrolled received analgesics, following the guidelines of the WHO. 50 p (48,07 %) continued with the same treatment Group I (control). 54 p (51,93 %) added antidepressants Group II (prior to pain 15 p), Group III (since the nset of pain 39 p). The diagnosis of depressive disorder was performed according to the DSM-IV criteria. The intensity of pain was quantified by a survey based on freee answers (FA) and a verbal scale (VS), the numeric scale (NS), the visual analogue scale (VAS) and by completing the McGill pain questionnaire MPQ (with adequations of compatibilization), the intensity of depression, by means of Beck's Depression Inventory (BDI), and saliva cortisol was measured. On the third month, the same parameters were repeated and both measurements were compared with appropriate biostatistical methodology. On the fourth month a consensus meeting with relatives and general practitioner was held to analyze the effects on the quality of life that had been quantified for mathematic analysis.

Results:

Oncologic pain is defined as pain of specific characteristics caused by the infiltrative inflammatory growth and distortive fo the primary tumor or its metastases. 95 % of the patients with oncologic pain suffered from depressive disorders. The levels of cortisol did not show significant variations...
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Index: LILACS (Americas) Main subject: Quality of Life / Hydrocortisone / Follow-Up Studies / Longitudinal Studies / Statistics, Nonparametric / Depressive Disorder / Diagnosis, Differential / Analgesics / Neoplasms Type of study: Diagnostic study / Practice guideline / Observational study / Prognostic study / Qualitative research / Risk factors Limits: Adolescent / Adult / Humans Language: Spanish Journal: Psicofarmacologia (B. Aires) Journal subject: Pharmacology / Psychology / Psychiatry Year: 2014 Type: Article Affiliation country: Argentina Institution/Affiliation country: Instituto de Oncología/AR

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Index: LILACS (Americas) Main subject: Quality of Life / Hydrocortisone / Follow-Up Studies / Longitudinal Studies / Statistics, Nonparametric / Depressive Disorder / Diagnosis, Differential / Analgesics / Neoplasms Type of study: Diagnostic study / Practice guideline / Observational study / Prognostic study / Qualitative research / Risk factors Limits: Adolescent / Adult / Humans Language: Spanish Journal: Psicofarmacologia (B. Aires) Journal subject: Pharmacology / Psychology / Psychiatry Year: 2014 Type: Article Affiliation country: Argentina Institution/Affiliation country: Instituto de Oncología/AR