Zhao Guixiang, Okoro Catherine A, Li Jun, White Arica, Dhingra Satvinder, Li Chaoyang
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA.
Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA.
Cancer Epidemiol. 2014 Dec;38(6):757-64. doi: 10.1016/j.canep.2014.10.002. Epub 2014 Oct 30.
A cancer diagnosis and subsequent treatments constitute a significantly increased psychological burden among cancer patients. This study examined the prevalence of current depression and the risk factors associated with a high burden of depression among cancer survivors in the US.
We analyzed data from 3550 cancer survivors (aged ≥ 18 years) and 26,917 adults without cancer who participated in the 2010 Behavioral Risk Factor Surveillance System. Depressive symptoms were assessed by the Patient Health Questionnaire-8 diagnostic algorithm. Participants with a total depression severity score of ≥ 10 were defined as having current depression. Prevalence and prevalence ratios were estimated by conducting log-linear regression analysis while controlling for potential confounders.
Overall, 13.7% of cancer survivors (vs. 8.9% of adults without cancer, P < 0.001) reported having current depression; the prevalence varied significantly by cancer category. Among cancer survivors, after multivariate adjustment for covariates, cancer diagnosis within a year, being in 'other' racial/ethnic group, divorced, separated, widowed, or never married, current or former smoker, or having histories of diabetes, disability, or depression were associated with significantly higher prevalence ratios for current depression; whereas being at an advanced age (≥ 60 years old), attaining educational levels of >high school graduate, or engaging in leisure-time physical activity were associated with significantly lower prevalence ratios for current depression.
Our results indicate that cancer survivors are at increased risk of current depression. Targeting cancer survivors at high risk of depressive issues may be especially important for clinical support and interventions aimed at improving mental well-being.
癌症诊断及后续治疗给癌症患者带来了显著增加的心理负担。本研究调查了美国癌症幸存者中当前抑郁症的患病率以及与高抑郁症负担相关的风险因素。
我们分析了参与2010年行为风险因素监测系统的3550名癌症幸存者(年龄≥18岁)和26917名无癌症成年人的数据。通过患者健康问卷-8诊断算法评估抑郁症状。总抑郁严重程度得分≥10的参与者被定义为患有当前抑郁症。在控制潜在混杂因素的同时,通过进行对数线性回归分析来估计患病率和患病率比。
总体而言,13.7%的癌症幸存者(相比之下,无癌症成年人中这一比例为8.9%,P<0.001)报告患有当前抑郁症;患病率因癌症类别而异。在癌症幸存者中,对协变量进行多变量调整后,确诊癌症在一年内、属于“其他”种族/族裔群体、离婚、分居、丧偶或从未结婚、当前或曾经吸烟,或有糖尿病、残疾或抑郁症病史与当前抑郁症的患病率比显著更高相关;而高龄(≥60岁)、达到高中以上学历或从事休闲体育活动与当前抑郁症的患病率比显著更低相关。
我们的结果表明,癌症幸存者患当前抑郁症的风险增加。针对有抑郁问题高风险的癌症幸存者对于旨在改善心理健康的临床支持和干预可能尤为重要。