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癌症患者中主要肿瘤实体的精神障碍四周患病率。

Four-week prevalence of mental disorders in patients with cancer across major tumor entities.

机构信息

Anja Mehnert, Elmar Brähler, Carina Szalai, University Medical Center Leipzig, Leipzig; Anja Mehnert, Martin Härter, Holger Schulz, Karl Wegscheider, Susanne Sehner, Uwe Koch, University Medical Center Hamburg-Eppendorf, Hamburg; Hermann Faller, Matthias Richard, University of Würzburg, Würzburg; Monika Keller, Sabine Sommerfeldt, University Hospital Heidelberg, Heidelberg; Joachim Weis, Anna Boehncke, Tumor Biology Center, University of Freiburg; Bianca Hund, Rhein-Jura-Klinik, Bad Säckingen; Bianca Hund, Katrin Reuter, University Medical Center Freiburg, Freiburg; Carina Szalai, Psychosocial Counseling Center for Cancer Patients, Zwickau; Hans-Ulrich Wittchen, Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies, Technical University Dresden, Dresden; Elmar Brähler, Universal Medical Center Mainz, Mainz, Germany.

出版信息

J Clin Oncol. 2014 Nov 1;32(31):3540-6. doi: 10.1200/JCO.2014.56.0086. Epub 2014 Oct 6.

DOI:10.1200/JCO.2014.56.0086

PMID:25287821

Abstract

PURPOSE

To provide the 4-week prevalence estimates of mental disorders in cancer populations.

PATIENTS AND METHODS

We enrolled adult patients with cancer from in- and outpatient care facilities, using a proportional stratified random sample based on the nationwide cancer incidence in Germany. Patients who scored 9 or above on the Patient Health Questionnaire (PHQ-9) were administered to the standardized computer-assisted Composite International Diagnostic Interview for mental disorders adapted for cancer patients (CIDI-O). A random sample of those with a PHQ-9 score that was less than 9 were selected for a CIDI-O.

RESULTS

A total of 5,889 patients were identified, which led to 4,020 participants (a 68.3% response rate); of those, 2,141 patients were interviewed. The 4-week total prevalence for any mental disorder was 31.8% (95% CI, 29.8% to 33.8%); this included any anxiety disorder (11.5%; 95% CI, 10.2% to 12.9%), any adjustment disorder (11.1%; 95% CI, 9.7% to 12.4%), any mood disorder (6.5%; 95% CI, 5.5% to 7.5%), any somatoform/conversion disorder (5.3%; 95% CI, 4.3% to 6.2%), nicotine dependence (4.5%; 95% CI, 3.6% to 5.4%), alcohol abuse/dependence (0.3%; 95% CI, 0.1% to 0.6%), any mental disorder resulting from general medical condition (2.3%; 95% CI, 1.7% to 2.9%), and any eating disorder (0%). The highest prevalence for any mental disorder was found in patients with breast cancer (41.6%; 95% CI, 36.8% to 46.4%), followed by patients with head and neck cancer (40.8%; 95% CI, 28.5% to 53.0%). The lowest prevalence was found in patients with pancreatic cancer (20.3%; 95% CI, 8.9% to 31.6%) and stomach/esophagus cancers (21.2%; 95% CI, 12.8% to 29.6%).

CONCLUSION

Our findings provide evidence for the strong need for psycho-oncological interventions.

摘要

目的

提供癌症患者中精神障碍的 4 周患病率估计。

方法

我们使用基于德国全国癌症发病率的比例分层随机抽样，从门诊和住院医疗设施中招募成年癌症患者。PHQ-9 评分达到 9 分或以上的患者接受针对癌症患者的标准化计算机辅助复合国际诊断访谈精神障碍（CIDI-O）。PHQ-9 评分低于 9 分的患者中随机选择一部分进行 CIDI-O。

结果

共确定了 5889 名患者，其中 4020 名患者（应答率为 68.3%）参与了研究；其中，有 2141 名患者接受了访谈。任何精神障碍的 4 周总患病率为 31.8%（95%CI，29.8%至 33.8%）；这包括任何焦虑障碍（11.5%；95%CI，10.2%至 12.9%）、任何适应障碍（11.1%；95%CI，9.7%至 12.4%）、任何心境障碍（6.5%；95%CI，5.5%至 7.5%）、任何躯体形式/转换障碍（5.3%；95%CI，4.3%至 6.2%）、尼古丁依赖（4.5%；95%CI，3.6%至 5.4%）、酒精滥用/依赖（0.3%；95%CI，0.1%至 0.6%）、任何由一般医疗状况引起的精神障碍（2.3%；95%CI，1.7%至 2.9%）和任何饮食障碍（0%）。乳腺癌患者的任何精神障碍患病率最高（41.6%；95%CI，36.8%至 46.4%），其次是头颈部癌症患者（40.8%；95%CI，28.5%至 53.0%）。胰腺癌患者（20.3%；95%CI，8.9%至 31.6%）和胃/食管癌患者（21.2%；95%CI，12.8%至 29.6%）的患病率最低。