Wada Saho, Shimizu Ken, Inoguchi Hironobu, Shimoda Haruki, Yoshiuchi Kazuhiro, Akechi Tatsuo, Uchida Megumi, Ogawa Asao, Fujisawa Daisuke, Inoue Shinichirou, Uchitomi Yosuke, Matsushima Eisuke
Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Section of Liaison, Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
J Pain Symptom Manage. 2015 Dec;50(6):768-77. doi: 10.1016/j.jpainsymman.2015.07.011. Epub 2015 Aug 20.
There is controversy around the association between depressive symptoms and age in adult cancer patients.
The aim of this study was to evaluate the following hypotheses: 1) cancer patients' depressive symptoms decrease with age, and 2) in individuals aged 65 years or older, depressive symptoms increase because of the effect of somatic symptoms.
We retrospectively analyzed a database of 356 cancer patients who were consecutively recruited in a previous multicenter cross-sectional study. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9), and correlations with age and other factors were assessed by hierarchical multivariate regression analysis. Age was entered as the dependent variable in the first step, patient characteristics and cancer-related variables were entered in the second step, and somatic symptoms were entered in the last step. We analyzed this model for both the total sample and the subpopulation aged 65 years or older.
In the total sample, the PHQ-9 score was significantly associated with lower age, fatigue, and shortness of breath (adjusted R(2) 14.2%). In the subpopulation aged 65 years or older, no factor was associated with the PHQ-9 score (adjusted R(2) 7.3%).
The finding that depressive symptoms in cancer patients decreased with age was concordant with our first hypothesis, but the second hypothesis was not supported. Younger cancer patients were vulnerable to depressive symptoms and should be monitored carefully. Further studies using more representative samples are needed to examine in detail the association between depressive symptoms and age in older cancer patients.
成年癌症患者中,抑郁症状与年龄之间的关联存在争议。
本研究旨在评估以下假设:1)癌症患者的抑郁症状随年龄增长而减轻;2)在65岁及以上的个体中,由于躯体症状的影响,抑郁症状会增加。
我们回顾性分析了一个数据库,该数据库来自之前一项多中心横断面研究中连续招募的356名癌症患者。通过患者健康问卷-9(PHQ-9)评估抑郁症状,并通过分层多元回归分析评估其与年龄及其他因素的相关性。第一步将年龄作为因变量输入,第二步输入患者特征和癌症相关变量,最后一步输入躯体症状。我们对总样本以及65岁及以上的亚组人群分析了该模型。
在总样本中,PHQ-9评分与较低年龄、疲劳和呼吸急促显著相关(调整后R²为14.2%)。在65岁及以上的亚组人群中,没有因素与PHQ-9评分相关(调整后R²为7.3%)。
癌症患者抑郁症状随年龄增长而减轻这一发现与我们的第一个假设一致,但第二个假设未得到支持。年轻的癌症患者易出现抑郁症状,应予以密切监测。需要使用更具代表性的样本进行进一步研究,以详细探讨老年癌症患者抑郁症状与年龄之间的关联。