Vyas Ami, Babcock Zachary, Kogut Stephen
Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Kingston, RI, 02881, USA.
J Cancer Surviv. 2017 Oct;11(5):624-633. doi: 10.1007/s11764-017-0635-y. Epub 2017 Aug 10.
Cancer diagnosis in adults is often accompanied by negative impacts, which increase the risk of depression thereby lowering health-related quality of life (HRQoL). We examined the association between depression treatment and HRQoL among US adults with cancer and depression.
Patients age 18 and above, with self-reported cancer and depression diagnoses were identified from Medical Expenditure Panel Survey database for 2006-2013. Baseline depression treatment was categorized as antidepressants only, psychotherapy with or without antidepressant use, and no reported use of antidepressants or psychotherapy. HRQoL was measured using SF-12 physical component summary (PCS) and mental component summary (MCS) scores. Adjusted ordinary least squares regressions estimated the association between type of depression treatment and HRQoL.
Out of 450 (weighted per calendar year: 2.1 million) cancer adults included in the study, 51% received antidepressants only, while 16% received psychotherapy with or without antidepressants. In bivariate analyses, the mean MCS score was lowest among those who received psychotherapy with or without antidepressants compared to those receiving antidepressants only and those with no reported use of either modality, p < 0.05. In multivariate analyses, there was no significant difference in HRQoL by type of depression treatment.
Despite treatment for depression, HRQoL did not improve during the measurement timeframe. Quality of life is a priority health outcome in cancer treatment, yet our findings suggest that current clinical approaches to ameliorate depression in cancer patients appear to be suboptimal.
Adults with cancer and comorbid depression should receive appropriate depression care in order to improve their HRQoL.
成人癌症诊断往往伴随着负面影响,这会增加患抑郁症的风险,从而降低健康相关生活质量(HRQoL)。我们研究了美国患有癌症和抑郁症的成年人中抑郁症治疗与HRQoL之间的关联。
从2006 - 2013年医疗支出面板调查数据库中识别出年龄在18岁及以上、自我报告患有癌症和抑郁症诊断的患者。基线抑郁症治疗分为仅使用抗抑郁药、使用或不使用抗抑郁药的心理治疗以及未报告使用抗抑郁药或心理治疗。使用SF - 12身体成分总结(PCS)和心理成分总结(MCS)分数来测量HRQoL。调整后的普通最小二乘法回归估计抑郁症治疗类型与HRQoL之间的关联。
在纳入研究的450名(按日历年加权:210万)癌症成年人中,51%仅接受抗抑郁药治疗,而16%接受了使用或未使用抗抑郁药的心理治疗。在双变量分析中,与仅接受抗抑郁药治疗的患者以及未报告使用任何一种治疗方式的患者相比,接受使用或未使用抗抑郁药的心理治疗的患者的平均MCS分数最低,p < 0.05。在多变量分析中,抑郁症治疗类型对HRQoL没有显著差异。
尽管进行了抑郁症治疗,但在测量时间段内HRQoL并未改善。生活质量是癌症治疗中的一个优先健康结果,但我们的研究结果表明,目前改善癌症患者抑郁症的临床方法似乎并不理想。
患有癌症和合并抑郁症的成年人应接受适当的抑郁症护理,以改善他们的HRQoL。