Influence of anxiety and depression on cellular immune function of patients with breast cancer before chemotherapy / 重庆医学

ABSTRACT

Objective To evaluate the effects of the comprehensive psychological intervention on anxiety and depression of the patients with breast cancer during chemotherapy ,and to explore the influence of depression and anxiety before and after chemother-apy on the cellular immune function .Methods A total of 81 married female patients with breast cancer were surveyed and assessed with self-designed questionnaire ,the Herth Hope Scale ,the Hamilton Depression Scale(HAMD) and the Hamilton Anxiety Scale (HAMA) .64 cases of breast cancer with depression and anxiety according with the included standards (HAMD scores ≥8 and HA-MA scores ≥7) were randomly divided into the intervention group(n=32) and the control group(n=32) .The levels of T lympho-cyte subsets(CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+ ) and the natural killing(NK) cells in peripheral venous blood were determined by the flow cytometry(FCM) .Results The Herth scores after chemotherapy in the intervention group were increased by 37 .19% than that of the control group ,while the HAMD scores were decreased by 36 .01% compared with the control group ,the differences be-tween them showing statistical significance (P<0 .01) .In the comparison between before and after chemotherapy ,the Herth scores in the intervention group were increased by 12 .57 ± 4 .57 ,while the HAMD and HAMA scores were declined by 9 .32 ± 1 .86 and 4 .35 ± 1 .15 respectively ,the differences showed the statistical significance (P< 0 .01) .Compared with the control group ,CD3+ , CD4+ ,CD4+ /CD8+ ratio and NK cells before and after chemotherapy in the intervention group were increased by 2 .10 ± 1 .63 , 1 .51 ± 1 .02 ,0 .05 ± 0 .02 and 0 .78 ± 0 .52 correspondingly ,the differences among them had statistical significance(P<0 .001) .The HAMD scores were negatively correlated with the CD4+ /CD8+ ratio(r= -0 .554) .Conclusion The cellular immune hypofunction in the patients with breast cancer is probably related with anxiety and degree of depression .The comprehensive psychological inter-vention model can improve the anxiety and depression mood during chemotherapy .