Alteraciones emocionales y psicopatológicas en pacientes oncológicos laringectomizados / Emotional and psychopathological disorders in laryngectomized oncological patients

Introducción y objetivos: Se desconoce si afrontar un cáncer de laringe y someterse a laringectomía total son experiencias tan impactantes emocionalmente para el paciente como los cánceres de otras localizaciones. El objetivo del estudio fue identificar la incidencia de sufrimiento emocional y psicológico en pacientes laringectomizados y describir sus matices sintomatológicos. Métodos: Estudio transversal descriptivo de la respuesta emocional y psicopatológica de 100 pacientes oncológicos sometidos a laringectomía total, evaluados inmediatamente tras la cirugía (N = 35), al iniciar la rehabilitación comunicativa (N = 23) y a los 5 años del diagnóstico (N = 42) frente a un grupo control de 55 sujetos sanos. La batería de evaluación psicopatológica para ansiedad, depresión, trastorno por estrés postraumático, intrusión, evitación y excitación constó de una entrevista específica, la Escala Hospitalaria de Ansiedad y Depresión (HADS) y el Inventario de Estrés Postraumático (IES-R). Resultados: Los pacientes laringectomizados presentaron baja incidencia de alteraciones emocionales y psicológicas como ansiedad (6,9%), depresión (5,9%) y/o trastorno por estrés postraumático (28,4%) con intensidad suficiente para constituir un diagnóstico psicopatológico. Un 57,4% de los pacientes presentaba malestar emocional difuso de carácter postraumático (el 52,6% de ellos), más prevalente e intenso en el grupo en rehabilitación. Conclusiones. Los síntomas de ansiedad, depresión y trastorno por estrés postraumático tras una laringectomía total no son de suficiente intensidad y cualidad para constituir entidades clínicas diagnosticables, sino cuadros de trastorno adaptativo. Son menores que los de pacientes afectados por cáncer de otras localizaciones y se presentan fundamentalmente en la fase de rehabilitación, donde deberían centrarse las actuaciones psicológicas preventivas y de apoyo (AU)

Introduction and objectives: It is unknown if patients who suffer from laryngeal cancer and undergo total laryngectomy experience as much emotional shock and psychological distress as patients with cancers in other locations do. The aim of the study was to identify the incidence of emotional and psychological disorders in laryngectomized patients and describe their symptomatological nuances. Methods: A descriptive cross-sectional study of emotional and psychopathological response of 100 cancer patients undergoing total laryngectomy was performed. The patients were evaluated immediately after surgery (n = 35), when initiating communicative rehabilitation (n = 23) and 5 years after diagnosis (n = 42), versus a control of 55 healthy subjects. Psychopathological assessment battery for anxiety, depression, intrusion, avoidance, arousal and posttraumatic stress disorder consisted of a specific interview, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R). Results: Laryngectomized patients had low incidence of emotional and psychological disorders such as anxiety (6.9%), depression (5.9%) and/or posttraumatic stress disorder (28.4%), but with sufficient intensity to constitute a psychopathological diagnosis. A significant level of distress was found in 57.4% of patients, with clear diffuse traumatic nature in 52.6% of them, which was more prevalent and intense in the rehabilitation group. Conclusions: Symptoms of anxiety, depression and posttraumatic stress disorder during different stages after total laryngectomy are not of sufficient intensity and quality to be diagnosable clinical entities; they can be considered an adaptive disorder. The symptoms are less than those of patients with cancer in other locations and appear mostly in the rehabilitation stage, where preventive performances and psychological support should be focused (AU)

Emotional and psychopathological disorders in laryngectomized oncological patients.

INTRODUCTION AND OBJECTIVES: It is unknown if patients who suffer from laryngeal cancer and undergo total laryngectomy experience as much emotional shock and psychological distress as patients with cancers in other locations do. The aim of the study was to identify the incidence of emotional and psychological disorders in laryngectomized patients and describe their symptomatological nuances. METHODS: A descriptive cross-sectional study of emotional and psychopathological response of 100 cancer patients undergoing total laryngectomy was performed. The patients were evaluated immediately after surgery (n=35), when initiating communicative rehabilitation (n=23) and 5 years after diagnosis (n=42), versus a control of 55 healthy subjects. Psychopathological assessment battery for anxiety, depression, intrusion, avoidance, arousal and posttraumatic stress disorder consisted of a specific interview, the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale-Revised (IES-R). RESULTS: Laryngectomized patients had low incidence of emotional and psychological disorders such as anxiety (6.9%), depression (5.9%) and/or posttraumatic stress disorder (28.4%), but with sufficient intensity to constitute a psychopathological diagnosis. A significant level of distress was found in 57.4% of patients, with clear diffuse traumatic nature in 52.6% of them, which was more prevalent and intense in the rehabilitation group. CONCLUSIONS: Symptoms of anxiety, depression and posttraumatic stress disorder during different stages after total laryngectomy are not of sufficient intensity and quality to be diagnosable clinical entities; they can be considered an adaptive disorder. The symptoms are less than those of patients with cancer in other locations and appear mostly in the rehabilitation stage, where preventive performances and psychological support should be focused.

Animal-assisted Interventions: Review of Current Status and Future Challenges

Previous bibliographic reviews have highlighted that Animal-Assisted Interventions (AAIs), though promising, may have some weaknesses in their empirical basis that must be addressed. Present study reviewed 228 references gathered through PyscINFO database, all of which included the terms animal and assisted within the key concepts field, providing several indicators of productivity (such as publications per year, the relative presence of different types of texts, the country and the language of publication, the author’s productivity and type of reference, and the main sources of information such as journals and research teams) and content (relative presence of different assisted interventions, methodology, areas of interest, and contents addressed by the most prolific authors) in the field. The number of texts on AAI published per year has increased only slightly in the last decade, and such texts have been published in mainly U.S. English-language sources. Animal assisted therapy appeared as the most researched intervention, although inconsistencies in the use of terms and definitions were found. Empirical studies represented most of the classified texts, although their prominence among the most prolific authors was low. It was detected that AAIs have an increasing empirical base, although the gap between research and dissemination keeps open. More research efforts will be necessary to cover the deficiencies identified in the field (AU)

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