肺癌诊断后抑郁症的发病率及危险因素：一项基于全国人群的研究。
Incidence and risk factors of depression after diagnosis of lung cancer: A nationwide population-based study.
作者信息
Hung Ming-Szu, Chen I-Chuan, Lee Chuan-Pin, Huang Ru-Jiun, Chen Pau-Chung, Tsai Ying-Huang, Yang Yao-Hsu
机构信息
Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Puzi City Department of Medicine, College of Medicine, Chang Gung University, Taoyuan Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi Campus Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi Branch Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei Department of Respiratory Care, College of Medicine, Chang Gung University, Taoyuan Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Puzi City School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan ROC.
出版信息
Medicine (Baltimore). 2017 May;96(19):e6864. doi: 10.1097/MD.0000000000006864.
This study aimed to explore the incidence and risk factors of depression after lung cancer diagnosis. Using the Taiwan National Health Insurance Research Database (NHIRD), incidences and risk factors of depression in lung cancer and nonlung cancer cohorts were analyzed.From 1998 to 2006, a total of 22,125 patients were included in each matched cohort of lung cancer and nonlung cancer patients from NHIRD. The incidence of depression was higher in the lung cancer cohort than in the nonlung cancer cohort (1545.8 vs 1366.6 per 100,000 person-years). An increased risk of depression was observed in the lung cancer cohort [adjusted hazard ratio (aHR): 1.16, 95% confidence interval (95% CI): 1.01-1.34, P = .0377]. In lung cancer patients, age ≤50 years (aHR: 2.72, 95% CI: 2.02-3.66, P < .0001), age 50 to 69 years (aHR: 2.34, 95% CI: 1.87-2.94, P < .0001), female gender (aHR: 1.50, 95% CI: 1.26-1.80, P < .0001), coronary artery disease (CAD) (aHR: 1.40, 95% CI: 1.08-1.82, P = .0113), and operation (aHR: 1.78, 95% CI: 1.46-2.16, P < .0001) were associated with an increased risk of depression. In addition, higher incidences of emergency room (ER) visit (4.76 vs 2.82, per person-year) and admission (5.73 vs 4.33, per person-year) were observed in lung cancer patients with depression than those without depression.Our results showed that early surveillance and intervention of depression should be advocated after a diagnosis of lung cancer.
本研究旨在探讨肺癌诊断后抑郁症的发病率及危险因素。利用台湾国民健康保险研究数据库（NHIRD），分析肺癌队列和非肺癌队列中抑郁症的发病率及危险因素。1998年至2006年，NHIRD中肺癌和非肺癌患者的每个匹配队列共纳入22125例患者。肺癌队列中抑郁症的发病率高于非肺癌队列（每10万人年分别为1545.8例和1366.6例）。在肺癌队列中观察到抑郁症风险增加[调整后风险比（aHR）：1.16，95%置信区间（95%CI）：1.01-1.34，P = 0.0377]。在肺癌患者中，年龄≤50岁（aHR：2.72，95%CI：2.02-3.66，P < 0.0001）、年龄50至69岁（aHR：2.34，95%CI：1.87-2.94，P < 0.0001）、女性（aHR：1.50，95%CI：1.26-1.80，P < 0.0001）、冠状动脉疾病（CAD）（aHR：1.40，95%CI：1.08-1.82，P = 0.0113）和手术（aHR：1.78，95%CI：1.46-2.16，P < 0.0001）与抑郁症风险增加相关。此外，与无抑郁症的肺癌患者相比，有抑郁症的肺癌患者急诊室（ER）就诊率（每人年分别为4.76次和2.82次）和住院率（每人年分别为5.73次和4.33次）更高。我们的结果表明，肺癌诊断后应提倡对抑郁症进行早期监测和干预。
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