Questionnaire investigation of radiation rectal injury with anxiety, depression and somatic disorder.

Bo Lian; Xin Ping Cao; Hai Jun Deng; Jun Jiang; Ke Wei Jiang; Xin Xiang LI; You Sheng LI; Guo Le Lin; Ji Hong Liu; Shou Min Bai; Feng Wang; Zi Qiang Wang; Ai Wen WU; Yi Xiao; Hong Wei Yao; Wei Tang Yuan; Wei Zhang; Zhen Zhang; Yan Bing Zhou; Teng Hui MA; Qing Chuan Zhao

Return

Questionnaire investigation of radiation rectal injury with anxiety, depression and somatic disorder.

Author: Bo LIAN ¹ ; Xin Ping CAO ² ; Hai Jun DENG ³ ; Jun JIANG ⁴ ; Ke Wei JIANG ⁵ ; Xin Xiang LI ⁶ ; You Sheng LI ⁷ ; Guo Le LIN ⁸ ; Ji Hong LIU ² ; Shou Min BAI ⁹ ; Feng WANG ¹⁰ ; Zi Qiang WANG ¹¹ ; Ai Wen WU ¹² ; Yi XIAO ⁸ ; Hong Wei YAO ¹³ ; Wei Tang YUAN ¹⁴ ; Wei ZHANG ¹⁵ ; Zhen ZHANG ⁶ ; Yan Bing ZHOU ¹⁶ ; Teng Hui MA ¹⁷ ; Qing Chuan ZHAO ¹
Author Information

1. Department of Digestive Surgery, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710000, China.
2. Department of Radiotherapy, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
3. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
4. Research Institute of General Surgery, Jinling Hospital, Nanjing 210002, China.
5. Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing 100044, China.
6. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
7. Department of General Surgery, Shanghai Ninth People's Hospital, Medical School of Shanghai Jiaotong University, Shanghai 200011, China.
8. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
9. Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510199, China.
10. Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medical, Tsinghua University, Beijing 102218, China.
11. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
12. Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China.
13. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University & National Clinical Research Center for Digestive Diseases, Beijing 100050, China.
14. Department of Colorectal and Anal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
15. Department of Colorectal Surgery, Changhai Hospital, the Navy Medical University, Shanghai 200433, China.
16. Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China.
17. Department of Colorectal Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, Guangzhou 510655, China.
Publication Type:Journal Article
Keywords: Anxiety; Depression; Psycho-somatic disease; Questionnaire survey; Radiation rectal injury; Somatic symptom disorder
MeSH: Aged; Anxiety; Cross-Sectional Studies; Depression; Female; Humans; Male; Middle Aged; Quality of Life; Rectum; Surveys and Questionnaires
From: Chinese Journal of Gastrointestinal Surgery 2021;24(11):984-990
CountryChina
Language:Chinese
Abstract: Objective: To observe the incidence and treatment of radiation rectal injury complicated with anxiety, depression and somatic symptom disorder. Methods: A cross-sectional survey research method was carried out. Patients with radiation rectal injury managed by members of the editorial board of Chinese Journal of Gastrointestinal Surgery were the subjects of investigation. The inclusion criteria of the survey subjects: (1) patients suffered from pelvic tumors and received pelvic radiotherapy; (2) colonoscopy showed inflammatory reaction or ulcer in the rectum. Exclusion criteria: (1) patient had a history of psycho-somatic disease before radiotherapy; (2) patient was unable to use a smart phone, unable to read and understand the questions in the questionnaire displayed on the phone; (3) patient refused to sign an informed consent form. According to the SOMA self-rating scale, PHQ-15 self-rating scale, GAD-7 and PHQ-9 self-rating scale, the electronic questionnaire of "Psychological Survey of Radiation Proctitis" was designed. The questionnaire was sent to patients with radiation rectal injury managed by the committee through the WeChat group. Observational indicators: (1) radiation rectal injury symptom assessment: using SOMA self-rating scale, radiation rectal injury symptom classification: mild group (≤3 points), moderate group (4-6 points) and severe group (> 6 points); (2) incidence of anxiety, depression and physical disorder: using GAD-7, PHQ-9 and PHQ-15 self-rating scales respectively for assessment; (3) correlation of radiation rectal injury symptom grading with anxiety, depression, and somatic symptom disorder. Results: Seventy-one qualified questionnaires were collected, of which 41 (56.9%) were from Guangzhou. Among the 71 patients, 6 were males and 65 were females; the mean age was (55.7±9.3) years old and 48 patients (67.6%) were less than 60 years old; the median confirmed duration of radiation rectal injury was 2.0 (1.0, 5.0) years. (1) Evaluation of symptoms of radiation rectal injury: 18 cases of mild (25.4%), 27 cases of moderate (38.0%), and 26 cases of severe (36.6%). (2) Incidence of anxiety, depression and somatic disorder: 12 patients (16.9%) without comorbidities; 59 patients (83.1%) with anxiety, depression, or somatic disorder, of whom 2 patients only had anxiety, 1 patient only had depression, 9 only had somatic disorder, 2 had anxiety plus depression, 4 had anxiety plus somatic disorder, 2 had depression plus somatic disorder, and 40 had all three symptoms. (3) correlation of radiation rectal injury grading with anxiety, depression, and somatic symptom disorder: as compared to patients in mild group and moderate group, those in severe group had higher severity of anxiety and somatic symptom disorder (Z=-2.143, P=0.032; Z=-2.045, P=0.041), while there was no statistically significant difference of depression between mild group and moderate group (Z=-1.176, P=0.240). Pearson correlation analysis revealed that radiation rectal injury symptom score was positively correlated with anxiety (r=0.300, P=0.013), depression (r=0.287, P=0.015) and somatic symptom disorder (r=0.344, P=0.003). Conclusions: The incidence of anxiety, depression, and somatic symptom disorder in patients with radiation rectal injury is extremely high. It is necessary to strengthen the diagnosis and treatment of somatic symptom disorder, so as to alleviate the symptoms of patients with pelvic perineum pain and improve the quality of life.