Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan; Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.
J Affect Disord. 2017 Aug 15;218:59-65. doi: 10.1016/j.jad.2017.04.050. Epub 2017 Apr 25.
To assess the risk of mood disorders among patients with colorectal cancer (CRC), a population-based cohort study was performed using the Taiwanese National Health Insurance Research Database.
The study cohort included 27242 patients diagnosed with CRC between January 1, 2000 and December 31, 2010. Four insurants from the general population without CRC were frequency matched to each case by age, sex, and index year/month to create the control group. Cox's proportional hazard regression model with hazard ratios (HRs) and 95% confidence intervals (CIs) was conducted to estimate the impact of CRC on the risk of mood disorders.
Patients with CRC exhibited a significantly higher risk of developing mood disorders (adjusted HR=3.05, 95% CI=2.89-3.20) compared with the control group. This phenomenon was also observed for each type of mood disorder (depression, bipolar disease and anxiety), as well as across different subgroups by patient characteristics. However, a follow-up time longer than 1 year was more likely to have significantly increased risks, and we unexpectedly found that some treatments in CRC patients tended to have a decreased risk of anxiety compared to their counterparts.
The findings of this population-based cohort study suggest that patients with CRC are at a higher risk of mood disorders, especially when follow-up time is longer than 1 year, but various treatments may inversely affect this association.
为了评估结直肠癌（CRC）患者发生心境障碍的风险，本研究使用台湾全民健康保险研究数据库进行了一项基于人群的队列研究。
研究队列包括 27242 例于 2000 年 1 月 1 日至 2010 年 12 月 31 日期间被诊断为 CRC 的患者。每例 CRC 患者按年龄、性别和索引日期/月份与来自一般人群中无 CRC 的 4 名参保者进行频数匹配，以创建对照组。采用 Cox 比例风险回归模型计算风险比（HRs）及其 95%置信区间（CIs），以评估 CRC 对心境障碍风险的影响。
与对照组相比，CRC 患者发生心境障碍（调整 HR=3.05，95%CI=2.89-3.20）的风险显著升高。这种现象也见于每种类型的心境障碍（抑郁、双相情感障碍和焦虑），以及按患者特征划分的不同亚组中。然而，随访时间超过 1 年更可能显著增加风险，并且我们意外地发现，与对照组相比，CRC 患者的某些治疗方法可能会降低焦虑的风险。
这项基于人群的队列研究结果表明，CRC 患者发生心境障碍的风险较高，尤其是在随访时间超过 1 年时，但各种治疗方法可能会对此关联产生反向影响。
