Nakash Ora, Levav Itzhak, Aguilar-Gaxiola Sergio, Alonso Jordi, Andrade Laura Helena, Angermeyer Matthias C, Bruffaerts Ronny, Caldas-de-Almeida Jose Miguel, Florescu Slivia, de Girolamo Giovanni, Gureje Oye, He Yanling, Hu Chiyi, de Jonge Peter, Karam Elie G, Kovess-Masfety Viviane, Medina-Mora Maria Elena, Moskalewicz Jacek, Murphy Sam, Nakamura Yosikazu, Piazza Marina, Posada-Villa Jose, Stein Dan J, Taib Nezar Ismet, Zarkov Zahari, Kessler Ronald C, Scott Kate M
School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel.
Psychooncology. 2014 Jan;23(1):40-51. doi: 10.1002/pon.3372. Epub 2013 Aug 27.
This study aimed to study the comorbidity of common mental disorders (CMDs) and cancer, and the mental health treatment gap among community residents with active cancer, cancer survivors and cancer-free respondents in 13 high-income and 11 low-middle-income countries.
Data were derived from the World Mental Health Surveys (N = 66,387; n = 357 active cancer, n = 1373 cancer survivors, n = 64,657 cancer-free respondents). The World Health Organization/Composite International Diagnostic Interview was used in all surveys to estimate CMDs prevalence rates. Respondents were also asked about mental health service utilization in the preceding 12 months. Cancer status was ascertained by self-report of physician's diagnosis.
Twelve-month prevalence rates of CMDs were higher among active cancer (18.4%, SE = 2.1) than cancer-free respondents (13.3%, SE = 0.2) adjusted for sociodemographic confounders and other lifetime chronic conditions (adjusted odds ratio (AOR) = 1.44, 95% CI 1.05-1.97). CMD rates among cancer survivors (14.6%, SE = 0.9) compared with cancer-free respondents did not differ significantly (AOR = 0.95, 95% CI 0.82-1.11). Similar patterns characterized high-income and low-middle-income countries. Of respondents with active cancer who had CMD in the preceding 12 months, 59% sought services for mental health problems (SE = 5.3). The pattern of service utilization among people with CMDs by cancer status (highest among persons with active cancer, lower among survivors and lowest among cancer-free respondents) was similar in high-income (64.0%, SE = 6.0; 41.2%, SE = 3.0; 35.6%, SE = 0.6) and low-middle-income countries (46.4%, SE = 11.0; 22.5%, SE = 9.1; 17.4%, SE = 0.7).
Community respondents with active cancer have higher CMD rates and high treatment gap. Comprehensive cancer care should consider both factors.
本研究旨在探讨常见精神障碍（CMDs）与癌症的共病情况，以及13个高收入国家和11个中低收入国家中患有活动性癌症的社区居民、癌症幸存者和未患癌症的受访者之间的心理健康治疗差距。
数据来源于世界心理健康调查（N = 66387；n = 357名活动性癌症患者，n = 1373名癌症幸存者，n = 64657名未患癌症的受访者）。所有调查均采用世界卫生组织/综合国际诊断访谈来估计CMDs患病率。受访者还被问及在过去12个月内的心理健康服务利用情况。癌症状况通过医生诊断的自我报告来确定。
在调整了社会人口学混杂因素和其他终身慢性病后，活动性癌症患者中CMDs的12个月患病率（18.4%，标准误=2.1）高于未患癌症的受访者（13.3%，标准误=0.2）（调整后的优势比（AOR）=1.44，95%置信区间1.05 - 1.97）。癌症幸存者中CMDs的患病率（14.6%，标准误=0.9）与未患癌症的受访者相比无显著差异（AOR = 0.95，95%置信区间0.82 - 1.11）。高收入国家和中低收入国家呈现出相似的模式。在过去12个月内患有CMDs的活动性癌症患者中，59%的人因心理健康问题寻求过服务（标准误=5.3）。按癌症状况划分，患有CMDs的人群的服务利用模式（活动性癌症患者中最高，幸存者中较低，未患癌症的受访者中最低）在高收入国家（64.0%，标准误=6.0；41.2%，标准误=3.0；35.6%，标准误=0.6）和中低收入国家（46.4%，标准误=11.0；22.5%，标准误=9.1；17.4%，标准误=0.7）中相似。
患有活动性癌症的社区受访者CMDs患病率较高且治疗差距较大。全面的癌症护理应考虑这两个因素。
