Alwhaibi Monira, Madhavan Suresh, Bias Thomas, Kelly Kimberly, Walkup Jamie, Sambamoorthi Usha
Dr. Alwhaibi, Dr. Madhavan, Dr. Bias, Dr. Kelly, and Dr. Sambamoorthi are with the School of Pharmacy, West Virginia University, Morgantown, and Dr. Alwhaibi is also with the School of Pharmacy, King Saud University, Riyadh, Saudi Arabia (e-mail:
Psychiatr Serv. 2017 May 1;68(5):482-489. doi: 10.1176/appi.ps.201600190. Epub 2017 Jan 3.
Depression treatment can improve the health outcomes of elderly cancer survivors. There is a paucity of studies on the extent to which depression is treated among elderly cancer survivors. Therefore, this study estimated the rates of depression treatment among elderly cancer survivors and identified the factors affecting depression treatment.
A retrospective cohort study design was adopted, and data were obtained from the linked Surveillance, Epidemiology and End Results (SEER) and Medicare database. Elderly individuals (≥ 66 years) with incident cases of breast, colorectal, or prostate cancer and newly diagnosed depression (N=1,673) were followed for six months after the depression diagnosis to identify depression treatment (antidepressants only, psychotherapy only, combined treatment with both antidepressants and psychotherapy, and no depression treatment). Chi-square tests and multinomial logistic regressions were used to analyze the factors associated with depression treatment.
In this study population, 46% received antidepressants only, 27% received no treatment, 18% received combined therapy, and 9% received psychotherapy only. Factors associated with depression treatment included anxiety, the percentage of psychologists at the county level, the number of visits to primary care physicians, ongoing cancer treatment, the presence of other chronic conditions, and race-ethnicity.
The study findings indicate that two-thirds of cancer survivors received depression treatment in the first six months after depression diagnosis. Our study findings indicate that racial-ethnic disparities in depression treatment persist and competing demands for cancer treatment may take priority over depression care. Also, the availability of psychologists may influence receipt of psychotherapy among cancer survivors.
抑郁症治疗可改善老年癌症幸存者的健康状况。关于老年癌症幸存者中抑郁症治疗程度的研究较少。因此，本研究估计了老年癌症幸存者中抑郁症的治疗率，并确定了影响抑郁症治疗的因素。
采用回顾性队列研究设计，数据来自关联的监测、流行病学和最终结果（SEER）与医疗保险数据库。对患有乳腺癌、结直肠癌或前列腺癌且新诊断为抑郁症的老年个体（≥66岁）（N = 1673）在抑郁症诊断后随访6个月，以确定抑郁症治疗情况（仅使用抗抑郁药、仅进行心理治疗、抗抑郁药与心理治疗联合治疗以及未进行抑郁症治疗）。采用卡方检验和多项逻辑回归分析与抑郁症治疗相关的因素。
在本研究人群中，46%仅接受抗抑郁药治疗，27%未接受治疗，18%接受联合治疗，9%仅接受心理治疗。与抑郁症治疗相关的因素包括焦虑、县级心理医生的比例、初级保健医生的就诊次数、正在进行的癌症治疗、其他慢性病的存在以及种族。
研究结果表明，三分之二的癌症幸存者在抑郁症诊断后的前六个月接受了抑郁症治疗。我们的研究结果表明，抑郁症治疗中的种族差异依然存在，对癌症治疗的其他需求可能优先于抑郁症护理。此外，心理医生的可获得性可能会影响癌症幸存者接受心理治疗的情况。
