Yang Yi-Long, Liu Li, Wang Yang, Wu Hui, Yang Xiao-Shi, Wang Jia-Na, Wang Lie
Department of Social Medicine, School of Public Health, China Medical University, 92 North 2nd Road, Heping District, Shenyang 110001, People's Republic of China.
BMC Cancer. 2013 Aug 22;13:393. doi: 10.1186/1471-2407-13-393.
A lot of empirical studies have been conducted to evaluate the prevalence of depression and anxiety among Chinese adults with cancer. We aimed to conduct a meta-analysis in order to evaluate the prevalence and odds ratios of depression and anxiety in Chinese adults with cancer compared with those without.
The three most comprehensive computerized Chinese academic databases-CNKI, Wangfang and Vip databases-were systematically screened through September 2012. PubMed and Web of Science (SCIE) were also searched from their inception until September 2012 without language restrictions, and an internet search was also used. Case-control studies assessing the prevalence of depression and anxiety among Chinese adults with cancer were analyzed. Study selection and appraisal were conducted independently by three authors. The non-weighted prevalence, pooled random-effects estimates of odds ratio (OR) and 95% confidence intervals (CI) were all calculated.
Seventeen eligible studies with a total of 3497 subjects were included. The prevalence of depression and anxiety were significantly higher in adults with cancer compared with those without (Depression: 54.90% vs. 17.50%, OR = 7.85, 95% CI = 5.56-11.07, P = 0.000; Anxiety: 49.69% vs. 18.37%, OR = 6.46, 95% CI = 4.36-9.55, P = 0.000), the same situation was also observed in subgroup of control groups, assessment methods and cancer types. Although no difference of depression was observed in studies utilizing clinical diagnosis compared with self-report, the OR of anxiety in adults with cancer compared with those without was higher in studies utilizing clinical diagnosis (OR = 8.42, 95% CI = 4.83-14.70) than self-reports (OR = 5.83, 95% CI = 3.64-9.34). The ORs of depression and anxiety in cancer patients compared with disease group (Depression: OR = 6.03, 95% CI = 4.23-8.61; Anxiety: OR = 4.40, 95% CI = 3.05-6.36) were lower than in those compared with normal group (Depression: OR = 13.58, 95% CI = 6.26-29.46; Anxiety: OR = 15.47, 95% CI = 10.00-23.95).
We identified high prevalence rates of depression and anxiety among Chinese adults with cancer. The findings support that the prevalence of depression and anxiety among adults with cancer should receive more attention in Chinese medical settings.
已开展了大量实证研究以评估中国成年癌症患者中抑郁症和焦虑症的患病率。我们旨在进行一项荟萃分析，以评估中国成年癌症患者与非癌症患者相比抑郁症和焦虑症的患病率及比值比。
系统检索了截至2012年9月最全面的三个中文计算机学术数据库——中国知网、万方数据库和维普数据库。还检索了PubMed和科学网（SCIE）自建库起至2012年9月的文献，无语言限制，同时也进行了网络搜索。分析了评估中国成年癌症患者中抑郁症和焦虑症患病率的病例对照研究。由三位作者独立进行研究选择和评估。计算了非加权患病率、比值比（OR）的合并随机效应估计值和95%置信区间（CI）。
纳入了17项符合条件的研究，共3497名受试者。与非癌症患者相比，癌症患者中抑郁症和焦虑症的患病率显著更高（抑郁症：54.90%对17.50%，OR = 7.85，95% CI = 5.56 - 11.07，P = 0.000；焦虑症：49.69%对18.37%，OR = 6.46，95% CI = 4.36 - 9.55，P = 0.000），在对照组亚组、评估方法和癌症类型中也观察到同样情况。尽管与自我报告相比，在采用临床诊断的研究中未观察到抑郁症患病率的差异，但在采用临床诊断的研究中，癌症患者与非癌症患者相比焦虑症的OR（OR = 8.42，95% CI = 4.83 - 14.70）高于自我报告研究（OR = 5.83，95% CI = 3.64 - 9.34）。与疾病组相比，癌症患者中抑郁症和焦虑症的OR（抑郁症：OR = 6.03，95% CI = 4.23 - 8.61；焦虑症：OR = 4.40，95% CI = 3.05 - 6.36）低于与正常组相比（抑郁症：OR = 13.58，95% CI = 6.26 - 29.46；焦虑症：OR = 15.47，95% CI = 10.00 - 23.95）。
我们发现中国成年癌症患者中抑郁症和焦虑症的患病率很高。这些发现支持在中国医疗环境中，成年癌症患者中抑郁症和焦虑症的患病率应得到更多关注。
